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I11Y4I ^i^igiMijiMMiJl

. '^^^^ f

In Ihe ttlxivB dittgrdio llie posiLiun of Ihe stomuch will be
Flenrly stten. together with its relation to other iaternul iirgana.
I, HUlmacli, partially covr^red by lh(^ liver mill lungs; III. Small
intestines: IV. Colon; V. I.«wer or sigmoid portion of the

PLATK \.~ IS'TERNAL ORGANS.

THE STOMACH

rrs DISORDERS, ind

mow TO Cure Them.

J. H. KELLOGG. M. D.,

f/tnUnI „/ ,ht

Mrduial

Miuianary ColUtrt. Oiuago. HI.

; Mtmbtr of llu SHI

m Gynct^ogi

CBl Sociri,

rr», of CyntMi,iy

amd ObUttti.

tf Scunu,

• lAt Soti-

•U ^ Hyg&nt af Praia : FanAw

«f Rtligi

MtCTBimpiiU :

Amtric

m Eltclrc

•-Thrraftutu AHOCiatioH; Amtri

can aimalo-

tt^alSxitlf^

Amtncan Mediial Aimialian; .

lley Mrdti,

il Auocialum; nf-SlaU Mldical

Saculy;

MaKigan

Stale Mtdical Sontlj; Superatlndtrnt

of lltt

BatUi Crttk (Afnh.i Santlarim

ILLUSTRATED.

MODERN MEDICINE PUB. CO.,

BATTLE CREEK, MICH.

CarcAGO: New Yofk: Lohejon

MV l^ATIENTS

This Book

Affectionately Dedicated

As eminent coroparative anatomist deflnea an animal as "a

[omacb with various organs appi'ndiKl, " — a definition vliich

presents in a very clear li^ht tlie relative Importance of ilie

CUomach In thi> association of ihc organs and structures wliicli

1 eoDBlltute the human as well as tlie animal bodj. Th« stomacli

[ must certainly bo regarded as Ihu center at tlio nutritiro proc-

a of tlie body, and any derail gi' me it t of its Tunctiona must

[ therefore result in disorder ot the entire organism.

The close relation between the condition of the Btoronch and

F that of tbe miiid lias bei'o observed even by the most primitive

} nations, and has led some of tht^m to regard the Htomach aa the

veritable seat of thp soul. There is sound truth in the ancient

[■German adapp, "As a man eateth, so is he."

It may truly be said that disorders of digestion are the most
rprevaleot ot all human ills, and investigators within the last
J twenty years have been msldng more and more clear the tact
L that the great majority ot diseases are primarily due to derange-
J taentot tbe digestive processes. The remarkable researches ot
l Pmfessor Bouchard, of Paris, and others, have shown that such
I diseases as consumption, typhoid fever, and cholera, as well as
I Bright's disease and analogous maladies, are indirectly, If not
C dirtvily, due to a disordered condition ot the stomach, as the
Liesull of which the defenses of the body arc broken down, and
f infection rendered possible.

Notwithstanding the great prevalence ot stomach disorders,

I «od (he large amount of knowledge and eiperienoe which have

I lieen accumulated by the profession in regard to them withip

b the last few years, it is nevertheless true that no other class of

P curable disorders has more frequently baffled the best directed

(efforts ot medical practitioners. This is doubtless owing to

the imperfect knowledge of the processes of digestion and of

the nature of the disorders to which the digestive organs are

subject which has prevailed from the earliest times to within n

comparatively brief period. Within tbe last score of years.

[31

G4!273

THE

however, marvelous progress has been made Id Ibe stud; of the
BtomActa and its work, through the use of the stomooh-tube. and
by the aid ot experimental researches undertaken by numerous
European and a few American investigators.

Ab the result of these inquirJea. a great many most interesting
and important facts have been discovered, which have almost
■wholly tevoIutionUed our ideas respecting the nature of di-
gestive ailments and successful methods of treatment.

One of the leading purposes of this book is to cull atl«nti«n
lo these newer facta in relntion to the digestive processes, and
especially lo point out their relation lo the pn-vention and suc-
cessful treatment of dyspepsia and allied ailments. As will be
seen by reference to the tiible of contents, the work embodies,
first, a brief sketch of the proc<>i»cs of digestion : then a consider-
ation of the causes of indigestion, and their bearing upon die-
tetic and other habits, to which is added a description of the
various symptoms presi-nt in functional diseases of the stomach.
together with the means by which they may be relieved, fol-
lowed by a consideration of each of the several classes of di-
gestive disorders, and the proper dietetic and other measures
necessary for their cure.

In the study of the practical part of the work, it will be
noticed that the measures of treatment recommended are of n
remarkably simple characicr. This may lead to the impression
that they are lucking ill elHcicncy ; hence it may be proper In
say in their defense, that many years of experience in the treat-
ment of a large number of patients of this class, in connection
with the Battle Creek (Mich.) Sanitarium, have fully established
the author in the belief that in the proper regulation of the diet,
In the varied uses of water as described in Bcientiflo hydrother-
apy, in the employment o( electricity. Swedish movements.
Swedish gymnastics, massage, and exercise, logelhcr with gen-
eral control of the habits of life, we have means of far greater
value than all others for combating those causes which give
rise to indigestion, and of aiding nature in her efforts for re-
covery from the varied morbid conditions resulting from the
numerous disorders commonly iocluded under the general term,
"dyspepsia."

The man who is suffering from indigestion Is sick, not in his
stomach alone, but in every cell and fiber of his body; there is
no souiidnnss in him. The patient, is well as his sfomsch. must

receive atteotion. Our aim must
tient'a Eympioms, but lo cure ti-
ls done, the symptoms disappear.

Cace has beeo taken to gii'e iia Eicuuratc and precise descrip-
tion ot the vatioufi measures oF treulmcut suggested, and to pre-
sent them ia such n manner that they may be readily available
to every reader; but to save the consumption ot space which
would be necessitated by a constant repetition or the descrip-
tion, the treatments are referred to by number. The numbered
paragraphs will be found in the chapter between pa^es 287 and
344, Ld which are described all the various measures ot treatment
suggested in this work.

The description of the newer methods of investigating dis-
orderi of the stomach, whereby it is now possible 10 apply to
their study the exact methoils of chemistry and biicioriologj-,
will, it is hoped, be of special interest to the reader. It is In-
deed Dot saying too much to assert that the nature of disorders ot
digestion may now be determined with as much accuracy as
thai of any other class of maladies, and that the old method of
ascertaining by experiment tht^ diet best adapted to an indi-
vidual case. Is no longer necessary, — at least where there are at
command the resources aSorded by recent progress In this branch
iif medical science.

The iudividuul who wishes to make use of this worli as u
means to his own recovery, must, first of all, carefully read the
entire work. He should then Bv«k. either with or without the
aid of B physician, to arrive at a correct diagnosis ot his case. It
possiblu, the services of a skilled physician should be employed .
a, toat moul taken, and the metliods of rxaminatioii described on
pages 134, 320, and 332, utilised. More light is thrown upon the
nature ot digestive dl.sturbances by the methods of examination
here referred to. than from all other sources combined. The
nature of the disorder being determined, it will be easy, by the
aid of the table of coDtent.i or the imieit. to liirn to the section
which deals with this purticular form of digestive disturbance ;
and tben, having become familiar with the causes of the trouble,
and the means ot preventing its aggravation, such rational
methods of treatment as will be efUcienl. and. it is believed,
successful in a majority of cases, may be carried out at home.

In conclusion, the author desires to remark thai it is not the
purpose of this book to undertake to displace the wise family

TBS BTOMACH.

pbysichm, but rather to aid and abet him Id the management of
a class ot maladies which ruquirog, pt^rhaps more iliaii all ethers,
I the thorough co-uperation o( the patient. That this may be
!UFed. it is necessary that the patient should be educated in
ation to [hi; nature ol liis m&lady aod the various methods b.v
whioh he may rcniler assistance in his own restoration to health.
The need of such a work has been made apparent to the writer
I many times in his own practise. For years past, bis patients
have been constantly demanding a manual which should consti-
tute, to some degree at least, a guide to them in their efforts to
recover a healthy digestion ; and it is hoped that this little work
will be found to give the information which every sufferer from
indigestion ought to have, and which every busy general practi-
tioner cannot but be e\itil to have his patients suffering from this
I class of disorders, possess.

number of cuts, some of which are original, and several
i. have been added to the text, which it is hoped will aid
n giving the reader a clear Idea of the subject presented.

TABLE OF CONTENTS.

ITS DISORDERS AND HOW TO

Moclt'rn researches — Germs and Iniligesiion — Pepsin
un<l putent metltcincs — Rekiioa ot dyspepsia to Insan-
ity and other disorders.

^ THE ORGANS OF DIGESTION

The healthy stomach — The alimentary canal ~ The
mouth — The saliva — Ptyalin — The teeth — Tempo-
rary teeth — Permanent teeth — The esophagus — Tht
stomach — The pepiio glnnds — The gastric juice — Pep-
Bio — RenniD — The pylorus — The small intestine —
The iotestinal Juice— The absorbents — The colon —
The liver — The bile — The pancreas — The pancreatic
juice — Amylopsin — Trypsin — Steapsin — Millc-eur-
dliDg ferment.

' FOODS

Animal and vegetable foods — Plants the only food-pro-
duoers— Food elementa-Classiflcalionot food elements
— Btarch — Sugar — Glucose — Millc sugar — Albumen —
Cuein — Fats — Sails- Indigestible elements — Condi-
menla — Food substaacea — Foods of animal origin —
Milk — Cheese— Eggs — Flesh — Fish and Fowl — SbeU-
fish — Oysters — Frogs — Lobsters — Salted and smoked
meats — Vegetable foods — Fruits, grains, and vegetables
— Legumes — Peptogens — Gluten — Dextrin — The nat-
ural diet of man — Vegetarianism — Uses of the several
food elements — Digestibility of various foods — Nutri-

tive values of

food substances.

THE DIQESTIVE FLUIDS

Alexis St. Martin — What the saliva digests- What the
gastric juice digests — What the bile digests — What the
pancreatic juice digests — What the intestinal juice di-
gests.

GENERAL VIEW OP THE DIGESTIVE PROCESS .
Maslicailon — Salivary digeatioo — Deglutition, or swal-

lowing — Stomach digeatloc

-Action of the pylorui-

THE 6T0HACS.

IntestiDHl digestion ~ Olher uses o( the digestive fluids-
Gastric juice BDd bile, &atiseptica — PeriBtaltto nctioo

— Absorption — How the diaphragm aids absorption —
The tacteals — The portal vein — Liver digestion — Gly-
cogen — Liver starch — The two doora, the liver and the
kidneys — Breathing and liver action — Vagaries of di-
gestion—Poison found in oysters.

THE MALADIES OP THE MODERN STOMACH . i

The causes ot dyspepsia — Conditions of healthy diges-
tioD — Causes of fermentation in the stomach — Disin-
fecting action of the gastric juice — Errors in diet —
Hasty eating — Experiments in relation to salivary diges-
tion ^Indigestion of starch — Relaiion of maltose to
digestion — Diseased teeth — Relation of detective teeth
to indigestion — Microbes ot the moutb — Disinfection
of the mouth — Giles Corey's dream — Tartar of the teeth

— Drinking at meals — Effects of tce-waler — Dr. Beau-
mont's experiments upon Akils St. Martin — Eating too
frequently — All-gone feeling in the stomach — Eating
between meals — Irregularity of meats — Rhythmical
action ot the intestines — Pro|>er number of meals —
Habits of ancient nations in relation to the number ot
meals- Habits of modern nations in relation to the num-
ber of meals — Opinion of Dujardin-Bcaumetz — Late
suppers and six-o'clock dinners — Eating when exhausted
-Effects of violent exercise upon the digestion -Rest
before and after meals — Sleeping after meals — Too
many varieties of food at one meal — Good and bud com-
binations of food — Hot and cold bathing after meats —
Errors in quantity of food — Overeating — An extraordi-
nary case — A case of dilatation of the stomach — Eating
too little — How much should a person eat ? — Regula-
tion of diet — Muscle -workers and brain-workers — Die-
tetic habits of Dickens and Newton — The quantity of
food required at different ages — Desserts — Cornaro^
Experiments ot Letheby and Parkea — Diet of pugilists
in training — Economy in diet — Dcflcicncy in necessary
food elements — Effects of an impoverished diet — "Pat-
ent flour " and " family flour "— Unwholesome graham
flour — Bogus gluten flours — Table relating to indiges-
tion ot food elements — Table showing proportion of
nitrogenous lo carbonaceous elements — Proper propor-
tion of nitrogenous and carbonaceous elements —Amount

COSTESTfl.

of food required for a day's rations — Quality of food —
Bad cookery — Fried food — "Uncooked food-— Cooking, a
sort of artJQciaJ ripcnlog of food elements — Why green
fruit and f aw vegetables are indigestible — Imperfectly
cooked food — Decayed foods — Shell-fish — Rapid decay
of animal tissuus after death — The true nature of beef
lea — Cheese and cholera morbus — Microbes of milk —
Soft food — Influence of soft fiiod upon the teeth of cows
and human beings — Too abundant use of fats — Decom-
position of fats in the stomach — Why butter is Indigest-
ible — Why tuts cause biliousness — Why fnls are ren-
dered indigestible by cooking — Why fnls Interfere with
Ihe digestion of other foods — The superior dietetic
value of nuts — Nut butter — The excessive use of sugar

— Relation of sugar to fermentation — Influence of sugar
upon the stomach and liver — Why the excessive use of
su^r causes diabetes and obesity — Excessive use of flesh
food — Relation of meat diet to rheumatism, g-out, and
Brighfs disease — Dnnger in the use of raw meal — Con-
diments — Beaumont's observations of the clTectB of con-
diments upon St. Martin — The excessive use of mustard
and pepper in Mexico, and the results — Effects of salt
H[xin digestion — Pickles — Vinegar — Vinegar eels —
Vinegar eels as parasites— Tea and coffee — Injurious
effects of tea and coffee upon digestion — Alcohol— Sir
William Roberts's experiments — Beaumont's experiments

— Tobacco — Influence of tobacco upon digestion —
Hard water — Alkalies^ Baking-powders — Perverted
iippeiites — Adulterations of food — Unseasonable diet —
Pressure upon the stomach — Bruin work — Lack of ex-
ercise — Mental impressions — Drugs— Laxatives — Pur-
gatives — Mineral waters— Sexual abuses — Diseases of
other organs — Inherited dyspepsia — Nursing bottles —
Infant foods — Paregoric — Mrs. Winslow's Soothing
Sirup — Worm teas — Dilatation of the stomach in chil-
dren—Undetermined causes — Impure water- Germs

IMPORTANT NEW DISCOVERIES RELATING TO

DIGESTION 1

The stomach'lube — Measuring the size at the stomach
— Clapotement — The author's method — Prolapsa of
stomach, kidneys, and other organs — Examinatioo of
stomach contents — Test meal — Facts determined by

10 THE fiTOMACB.

test meal — Bacteriological examination of the Btomach
contenLa — Gcrma of Ibe stom&ch — CoefflcicDts — Ct&ssi-
flcation of stomach disorders — Hyperpepsia — Hj-po-
pepsia — Apt^psiu — Simple dj'Bpepsin,

8YMPTOM3 OF DYSPEPSIA ..... 1

ClBSHification ut iiidigeBlions — Prini'ipal Bymploms of
indlgfsiion — Symptoms periaiuing lo the moulh —
Symptoms porlaining to the throat — Symptoms pertain-
ing 10 the esophagus — Symptoms pertaining to the
stomach — Disturbances of the motor functions — The
discharges — Symptoms pertaining to the rectum —
General nervous symptoms — Pliysical signs.

THE SYMPTOMATIC TREATMENT OF INDIGES-
TION I

Uneasiness at the stomueh— Flatulence — Fermentation
— Acidity — Acidity from hyperpepsia ^Hi-arlbura —
Water-brash, or pjTosls — Niiusca — Vomiting — Rogur-
gitalion, ruminuliou, or mcrycism — Gripes, or colic —
Weight, constriction, tightness, etc.— Piiin — Biliousness

— Appe&rance of the tongue — Aphthie — "Throat-all"

— Sour taste in the mouth — Constipation — Diarrhea —
Backache — The stools — The urine- Dryness of the
skin — Skin eruptions — Cold feet, etc. — Headache —
Migraine, or nervous headache — Nervous apoplexy —
Disturbance of the circulation — Nocturnal asthma of
indigestion — "Stomach cough" — Nervous symptoms

— Nervousness — Disturbances of sight, hearing, etc. ~
N'.-rvouB diseases — Unusual drowsiness — Sleeplessness —
Heiital disorders — Dilatation of theBlomaah — Prolapse
iif the stoniafh,

TREATMENT OF DYSPEPSIA 2

Diet and regimen — Dietetic rules — Diet tables- Diet
List No. 1, aseptic dietary- Diet List No. 2, dry dietary

— Diet List No. 3, nitrogenous dietary — Diet List No. 4,
farinaceous preparatious^Diet List No. 5, milk — Diet
List No. 6, eggs and milk — Diet List No. 7, easily disin-
tegrated foods — Diet List No. 8, anti-fat dietary —Diet
List No. 9, fat and blood dietary — Diet LislNo, 10, fruits
and nuts— Diet List No, 1 1, Hquiddietary — Diet List No.
12. fever diet— Diet List No. 13, unfermented breads-
Diet List No. 14, for a hottle-(ed infant under six
moDtfaa of age— Diet List No. 15, for a teething infant

CONTBNTB. 1

— Diet List No. 16, (or a ciiild from one to five years of
age — Diet List Ko. 17, ctttiDg (or strength— Diet List
No. IS, diet for udulla — Diet List No. 10, for rheumatism
and gout — Diet Dat No. 20, tvt gustritis — Diet List No.
21, Tor constipation — Diet List No. 22, srticies diflicult
ot digestion — Foods not easy of digestion — Diet List
No. 23, foods wlitcti promote fennentation aud decom-
position in the stomach — Di*t List No, W. nutritive
encmata — Diel List No. 25, health foods — Zwiebaclt —
Granose — Granola — Gluten biscuit — Caramel-cereal —
Bromoae — Nut meiil and nut butler — Goflo — Kumy
zoon — Flesh food — Antisepsis of the minith — Sln'pli-
dyspepsia — Acid dyspepsia — Bilious or foul dys pepsin,
or aeptio indigestion — Paiatul dyspepsia — GasiHu
neurasthenia, or nervous dyspepsia — Hypopepsia and
apepsia — What about pepsin ? — Hyperpcpsia — Catarrh
of the Btomach — Starch indigestion — Intestinul Indi-
gestion — Torpid liver — Infaiuile dyspepsia — An im-
portant caution — Chronic catarrh of tlie atomaeh —
Ulcer of the stomach — Cancer of the stomach — Con-
stipation,
REMEDIES FOR THE HOME TREATMENT OF DYS-

PEPSIA 2

The sponge or hand bath — The full biith— The salt
glow^ — The shower bath ^ The tubbing wet-sheci —
The wet-sheet paclt — Tho trunk pacl; — The hoi and
cold trunii pacli — The wet girdlo — Fomentation —
Mustard or turpentine fomentation — Dry heat — Tho
toot bath — The sitz or hip bath— The aun balh — The
vapor bath — The hoi-air bath — Hot and cold to the
spine — The hot and cold pour, or pail douche — The
hot and cold full balh — The enema- The colociys
ter — The cold and tlie graduated enema — The laxa-
tive enema — The oil enema — Oil rubbing — Massage,
kneading — Abdominal massage — Massngo ot the
bowels — Massage of the stomiich —Replacement of
the viscera — Inspiratory lifting of the abdominal con-
tents — Hacking — Beating — Qflneral massage — Exer-
cise — Exercises to develop the abdominal muscles —
Breathing exercises —Chest lifting — Manual Swedish
movements — For general debility and anemia — For
dilatation of the stomach — For prolapse of the stomach,
bowels, colon, kidneys, and other abdominal organs —

TRE 8TOHA.0H.

For dyspepsia with dilatation of the atomach — For
constipation — The dry abdominal bandage — The ab-
■JDinlii.il supporter — Lavage — Hot and cold lavage ot
the stomach — CharcoMl — Cliarcoal taJjleta — AntiBeptio
charcoal tablets — Lactic acid — Hydrochlorio acid —
Laxatives — Caacara sagrada — Aqua sallna — Seltzer —
Sulphur — Antiseptic dentifrice — Cinnamon solution

— The Perfection VapotiKer — Benzoin solution —
Guaiac solution — Subcarbonate of bismuth — Bubgal-
tat« at bismuth — Bicarbonate of soda — Local applica-
tions of laradio electricity — General app.ications of
taradic eleclrieily — The high tension sinusoidal current

— Thi: low tension sinusoidal current — Oalvani nation of
the spine and abdomen — Oalvanizalion of the sympa-
thetic nerve — ^The rest-cure — General nutritive treat-
ment — Geiii-rul tonic treatment — Mechanical Swedish
movements — The vibrating chair- Mechanical knead-
ing — Trunk rolling — Pelvis tiltinir — Mechanical res-
piration— Cannon-ball massage — Water-drinking— The
hunger-cure — Healthful dress — Sleeping — Traveling

— Mental and moral trealmi'iit.

QUACKS AND NOSTRUJrfS 3

Sloughloii Bitters — Brown's Iron Bitters — Hop Bitters

— Hostetter's Bitters — German Bitters — tilomauh Bit-
ters — French Absinthe — Vinegar Bitters— Lee's Anti-
bilious Pills— Tropic Fruit Laxativi-- Carter's Little
Liver Pills — Simon's Liver Regulator — Radway's Regu-
lating Pills- Eno's Fruit Salt-- Hamburg Ten — Qar-
Beld Tea — Holloway's Pills — Hamburg Drops — R.V.
Pierce's Pleasant Purgative Pullets— Dr. Hall's Ho-ealled

GRAPHIC METHOD 3

Explanation of the Author's Graphic Mode of Repre-
senting the Results of Stomach Work, obtained from the
Examination of the Stomach Fluid by the System of In-
vestigation Employed In the Hyjrienic and Physiological
Research Laboratories of the Sanitarium at Battle Creek,
Mich., U. S. A. — The coplfi<-ipnls of digestive work.

LIST OF ILLUSTRATIONS.

Fig.

10.

Fio.

11.

Fig.

12.

Fig.

13.

Fig.

11.

Fig.

15.

Fio.

16.

Fio.

17.

Fio.

18.

Fig.

19.

Fig.

20.

Fio.

21.

Fig.

22.

Fig.

23.

Fig.

24.

Fig.

25.

Fio.

20.

Fig.

27.

PAOR.

•The Salivary Glanbs 22

■ToB Temporary Teeth 23

•Thb Permanent Teeth 2-1

■The Stomach 25

Peptic Gland 2(5

•The Alimentary C\\nai 27

The Absorbents 2d

•A. Pancreas; B. Diodkntm: C. Spleen 30

Starch Granules 32

The Mesenteric Glands and Lacteals . 50

Diagram of the Circulatory Systems 51

Human Teeth Covered with Tartar 04

Human Teeth Injured by Tartar 04

Teeth of Healthy Cow 101

Teeth of Cow Fed on Distillery Slops 102

Vinegar Eels 113

Yeast 159

Uric Acid Crystals 189

Shower Bath 291

Simple Shower Bath ... . 292

Rubbing Wet-Sheet 293

■Wet-Sheet Pack 294

Fomentation 295

Hot Water- Bag 296

Spine Bag 296

Foot B.\th ........ 297

The Sitz Bath Tub 298

[18^

THK STOMACH.

Fio. 28. — Vapob Bath 299

Fio. 29. — Stphon BYRHiaE 301

FiQ. 30.— Fountain Sviunob 302

Fio. 31.— Water Bottle and Syrisoe Combined 303

Flo. 32.— Ann Flexion 308

Fio. 3." — Ana Exteksios 309

Fig. 34.— Exercibe to Strenothen Trunk Mubcleb 312

Fig, 35. — Lyino, Knee Bekdtso 314

Fio. 3(1,— Chest Lrenso . 315

Fio, 37,— S.\CRUM Beatibo 31C

Fio. S8. — Esercibe for Abdominal Musclkb 318

Fig, 39.— Stasdinq, Stoewath Bbndiso .... 310
Pi(i. 40,— NATtTKAL AuDOMtNAi. Supporter . .320

Fib. 41,— STOMAcn-TuBK .331

12,— PBRpEn-roK VAroRizEH . , , . ^2:<
Fio, 43.— V,

LIST OF PLATES.

Pi^TB I. — The ISTEIiHAL OBOANa< colored) Frontitpiete.
Platk II.— Miciio-OBOANisMa 128

F!g. 1.— Micrococci amingod in cbftlnB («Mptococo( ).

Fig. ).— MIcrococcrl In pulr. {diplixotet).

Fig. B.— Micrococci In a mass ur Birarm (nmtrlfrn).

Fig. 1.— Micrococci arranged la groups of tuur. toand !□ tlie
spulB of coasumptlve patlouta.

Fig. B.— Micrococci of pneumonia.

Fig. t.~BacXtria Urmo, found In decoinpoalnit matter.

Fig. T.— BacTerliteCerino. magnlfii!d40(»<l[ami'tcr».

Fig. B.^BticlIlusfuIi((!fa. bay bacillus foand uu manure or lu a
decoction ot bay.

Fig. 0.— Boelcrla [fncolo, germs from stagnitnt water: some-
times seen Id slimy masses on rottcD potatoes ; also
found In irell-iTBter.

Fig. 10.- Bacillus ot typhoid fever.

Pig. 11.— BacUluti of malaria, found In tbe blood In cases of
mala rill I fever.

Fig IS,— Bacillus of tnbercalosls.

Fig. 13.— Bacillus of leprosy.

Fig, U.— SplrRIa tlndubt. launil actively moving In decom-
posing tnfu»lou9.

Plg.lS.-

-Cholera germs.

Pig. 18.-

-SjXr((J»ffl iNiliKomi. a. germ with Baeftla. found In

marsh water.

Flg. 17,-

FlB.18.-

containing decomposing animal or venetablc matte

Fig. IB.-

- Wiabdi,m„nws r<mr,a. germs which form the rod-colored

Flg.».-

-A germ similar to the preceding, of a pate-red color,

found In stagnant water.

Fig.n.

Fig.aa.-

Fig.sa-

-Germs of cholera.

Flg, 24.-

- A germ which causes fermentation.

FlB.SS.-

-Germs of anthrax In blood from spleen of mouse.

Pig. 28.-

- Gorma of anthrax grown on a potato.

Flg, 37.-

-Germs of anthrax at a different stage of growth.

FKf,a8.

- Foul water germ In dlllereDt stages of growth.

Plate III.

— AmUALCULES AKD ISFCBORIA IN IVatER

Plath IV,-

- DispLACEiCENTB or THE Stomach .

Flg. 1.-

-visceral dlsplacomeot.

Fls. 2.

-Displaced viscera.

Fig. 3.-

- Results of corset constriction (woman of thirty ).

Flg *.

-Dlsplacemenfsof spleen and other vlscera-

Fig, S,

- Woman who had worn a " health corset."

Fig. B.— Bad standing corrected (J

^^^^ 16 THE BTOMAoa.

^^^K Fig. 7.— BudstandliiKCorrralAdfwcimaD).

^^m Fig. 9.- Kcaulta of corset constriction.

^^^m Vig. 11.— WtjmaD chd had worn a. " boultli comet."

^^B Plate V-— Germs {colored} ....

. m

^^^^1 FIK'I-~ Month germs toUDCl upon the surface of u

coaled

^^^L tongue, grc&tly mBpniatd.

^^^K Ftg. S.- Germs trhlch cause deouy of Itie teeth.

^^^P FlB.a-Oonns found In Iho stomaeh Quid uttar n tes

^^^1 greatl; moBuiacd.

^^^H Pl^TE VI.— MOVEMEHTB OF MAEaAQB

. 301

^^^B Fig. l.-Suportlclittkueadlng.

^^K Fig. S.-DeevkaeatllDe.

^^^B Fig. 3.— MasHitga of tbo abdomen.

^^^K Fig. 4.— HuMageotthelfoircla.

^^^B Fig. B.— MiuBagoof tbOHtomikCh.

^^^B Fig. Il.— ltep1aclng of the viscera.

^^K Pig. T.-IuBplratorrllftluK of the viscera.

^^K Fig. B.- Hacking.

^^B Fig. «.- Beating.

^^^B Fig. 12.- Full breathing.

■^^^^^1

^^V Plate VII. — Massaoe

M^^^^l

^^H Fig. 1. -Trunk nilllna.

' ^^^^1

^^H ng. -i.- Vlbruilnf: chiilr.

^^B Pig. 3.- Pctvli tilting.

^K Plate Vin.-MAa>^A.;E

. S35

^^B Fig. 1.- Mechanical knradlnz.

^^H Fig. Z- t-annoo-bull oias^uEi-.

^^^^b KIg. 3.— Mechanical reaplrHlloii.

^^B Platk tX.— Hbalthitl and Ahti.'TU- Orb^^

. ai2

^^H Fig. 1.- Varl«t« Costume.

■

^^B Flg.3.'Freedom Waist wllh >ktri.

^^^1 Flg.a.— NortolkJaCketwltb skirt of Bunlnoas full.

^^H Fif. 4.- Womab-s Practical Bu»nie.5 Costume.

^^^H Plate X.— Healthful Drbss

. 343

^^^K Figs. Sand B.-DlTtded Skin wub circular yoke. K

loker-

^^^K boekers.

^^^H Fig. 7.— Woman's Practical Buslucss CostuDi<>. win

Kklrl

^^^1 opened Id back to ihnw divide.

^^r Pigs. » and e.-Shlrt »alsi.

^^m Fig- IU.-E<kirt «ltb circular yoke.

^^^ Figs. 11 and 1!-— Colon suit.

^^^ft Plate XI.— Gbapbic Uethoo < colored )

, -m

^^ ^^^^

THE STOMACH:

Its Disorders and How to Cure Them.

Some years ugo, while calling upon u professional
friend in London, a Itjading English practitioner, he
remarked, "I sappose that in America you have chiefly
to deal with dyepeptiCB." In reply, I could not bat
acknowledge that Americans enjoyed the unenviable,
bat nevertheless deserved, reputation of being a nation
of dyspeptics ; but added that the treatment of inva-
lids in America was by no means so monotonous as
might Bcem to be the case, for the reason that the
general physical deterioration and vital dorangementa
occaBioncd by dyspepsia give rise to a vast number of
varied and complicated ailments which tax to the nt-
moBt the skill and ingenuity of the practitioner.

Indigestion, however, is by no means confined to
America. The special manifestations of impaired
digestion which are oxperientjod in the stomach itself,
and which most readily attract attention, are perhaps
I more comnion in tho United States than elsewhere,
being a natural result of the hasty and disorderly hab-
its of eating so usual among us. In England, Aus-
( tralia, New Zealand, and other English colonies, while
f there ia less complaint of indigestion, there is, never-
[ liieless, evidence of the same prevalence of derange-
a [171

TBB BTOUaCH.

meiits in the digestive and nutritive processes, as is
shown by the frequency witli which rhenmatism, gout,
kidney und bladder diseases, and varioaB nervooa
affections lire encountered.

Modern researches into the relations of various
maladies have shown that not only Bright's disease and
the other complaints mentioned, but also pulmonary
consumption, jaundice, many affections of the liver,
typhoid fever, tapeworm, malarial disease, organic
diseases of the spine and brain, and even insanity, are,
in a targe proportion of cases, due either directly or
indirectly to the vital disturbances arietiig from a
morbid condition of the stomach.

Dyspepsia is unquestionably the foundation of the
greater share of all chronic maladies. When in a
liealthy state, the body is able to defend itself, not
only against germs, but against all other ordinary
causes of disease ; but the general vital deterioration
re-sulting from indigestion weakens the defenses of the
body and its vital resistance, and renders it a prey
to every malady.

The function of a tissne or an organ depends upon
its structure ; and the structure of every cell and fiber
of the body is dependent upon the quality and quan-
tity of the material absorbed fi-om the alimentary canal.
A deficient supply of food weakens the structure and
lessens the energy of the organ. An excess of food
overwhelms the tissues with imperfectly oxidized and
toxic substances, whereby their structure is deteriorated,
and their functions perverted or retarded. Food con-
taining toxic substances produces in the body general
or specific toxic effects. The same thing results from

THK STOMACH.

dt'Vflopmtiiit of toxic substances in the alimentary
(.■jiiiul from tlie fermentation or putrefaction of food in
tlie stomach and iutestinee.

Pasteur, David, and others liave shown that the
mouth, the stomach, and tlio intestines are continually
inhabited by a vast nuinbor of microbes capable of pro-
ducing various acids, poisonous ptomains and toxins,
varying in their physical and physiological properties,
some of rhom being capable of producing powerfully
poisonous effects. Tliese poisons exist in greater or less

' quantity; but, owing to the poison-destroying power of
the liver and tlie eliniinative function of the kidneys,
the amount at any time circulating in the tissues of a
healthy person is not sufficient to produce any more
deleterious effect tlian that gradual deterioration of the
organism by which the tiesue-modificatinus character-
istic of old age are brought about. When, however,
diseased conditions of the stomach or intestines exist,
these poisons may be increased to an enormous degree ;
for example, Bouchard has tiliown that if food is re-
tained in the stomach more than five hours, the changes
which take place are fermentative and putrefactive,
rather than digestive. This explains the relation dem-
onstrated by Bouchard and others between dilatation of
the stomach and chronic rheumatism, and the lowered
vital resistance which, hy dyspepsia, prepares the way

I for tubercular disease of the lungs.

That something is wrong with the modern stomach

I is evident from the great number of remedies advertised

[ in the newspapers, and displayed upon every druggist's
ves, as capable of aiding a weakened stomach,

I Pepsins, peptones peptonoids, and various <

ferments are manofaotured by the ton. Notwithstand-
ing all these helps, however, the average etomach in
civilized lands grows weaker year by year, and disorders
growing out of indigestion multiply with alarming ra-
pidity. Many persona suffer fnim disorders of digestion
without being aware of the fact. Headache, backache,
bladder and kidney disorders, sleeplessness, depression
of spirits, wcaknesB, lack of energy, coldness of the
extremities, nervous sensations of various sorts, even
hysteria, epilepsy, and insanity, may exist as the i-esult
of indigestion witliout any Buffering in the stomach,
or anything to euggest to the patient bimst-lf or to
the untrained observer, any disnrdi;r of digestion. In
every case of chronic diaease, the stomach should be
carefully investigated. A coated tunguo ia always
indicative of a disordered stomach. The same is true
of numerous other s_>Tuptcinis from which many people
liuffer, such as a b:id ta^to in tlie mouth, duiness or
headache after eating, nervous bcadiiclie, etc.

Indeed, dyspepsia is a malady which demands the
most serious attention. This is especially apparent
wlien we recognize tho fact that, of all chronic ailments,
it is preeminent as being preventable by the employ-
ment of proper means. No disease is more dependent
upon conditions which the individual himself can con-
li'ol than is this ; neither is there any malady which
more readily yields to the application of appropriate
remedies when the necessary conditions are supplied.
I have no hesitancy in asserting that every case of
purely functional disease of the stomach may be cured,
provided the requisite conditions can be obtained.

THE ORGANS OF DIGESTION.

The Healthy Stomach. — Tlie coiKlitions of a
diseased fltomach cannot be underatoiid witliout a clear
knowledge of the healthy etomach and its functione.
Digestion is the process by wliich tlie food is dissolved
and rendered capable of absorption into the body.
All animals digest, and even plants digest by means
of their leaves. The following brief description of the
digestive pi'tifesH is largely taken from a text-book of

L physiology and hygiene by the author : '—

The Alimentary Canal. — -The process of di-

• gcstion is chiefly performed in a long tortuous tnbe
called the alimentary canal, which is from twenty-five to
thirty feet in length, and reaches from the mouth to

i the lower part of the trunk.

The digestive organs consist of this canal and other

I organs closely connected with it, including various
glands. The latter produce peculiar fluids, by which
the food is changed in several very remarkable ways, as
we shall presently learn. The several organs which
take part in the process of digestion may be named as
follows : —

The mouth, tongue, teeth, salivary glands, esoph-
^is, stomach, small intestines, colon, liver, and
pancreas. (The relative position of the liver, stomach,
and intestines is well shown in Plate I.)

1 "Second Bunk In Pliyslulogy siid HyKionv," by J. H. Eiillug^. M, D.,
published by the Amerlcuu Booh (^impany, TUe work may be obtnlned
from the Modem McdlclDu FaliUsLInK Oumiiany, Battls Cruuk. MIr'h,

THE STOMACH.

The Mouth. — The cavity of the mouth is the
expanded upper portion of the alimentary canal. It

contains tlie teetli and the tongue, and receives small
dnctB, or canals, from the three pairs of salivary glands
closely connected with it. These glands produce a
fluid known as saliva. At the back part of the mouth
are found, one on each side of the tonsils, glands which

Fiu. 1.— The SALiVAttr Glands.

help to form the saliva. The saliva contains an active
principle known as ptyaliii. (Fig. 1.)

The Teeth.— A tooth presents three parts for
examination : the portion which is seen above the
gum, called the crown ; the portion which is embed-
ded in the jaw, called the root; and the narrowed por-
tion which joins these two parts, called the neck. The
interior of the tooth is filled with a tieshy substance,

OSGAKS OF blOESTlON.

a.'i

the pulp, containing the blood-vessels and the nervea
which nonrish the tooth and give it sensibility. The
body of the tooth ia made up of a tissue resembling
bone. The portion which projects from the gum is
covered by a very hard, emooth substance, called
enamel, which is eo brittle as to be easily broken
by violent contact with hard substances.

Temporary Teeth.— The teeth which appear in
infancy and early childhood are called temporary,
or milk, teeth. These teeth usually make theii" appear-
ance between the ages of seven months and two years.
Thoy are twenty in nnmber, and consist, in each jaw,
of four front teeth, or incisors, two cnspids, one on
each side of the incisors, and four molars, or double
teeth, two on each side. (Fig. 2.)

THE BTOMACH.

Permanent Teeth. — At the age of six or sev-
en years the temporary teeth begin to give place to the
permanent set, which, when complete, at the age of
seventeen to twenty, nuinbers thirty-two, each jaw con-

Fia. S.— Tbb Pobuakes't Teeth.

taining, in addition to those of the temporary set,
fotir email double teeth, or bicuspids, and two addi-
tional molars, the so-called wisdom teeth. The laat
of the temporary tooth should give place to the perma-
nent ones not later than the twelfth year. (Fig. 3.)

I OF DIOESTION.

The Esophagus.^ In the act of swallowing,
the food passes from the moutii downward through
a narrow passage about nine inches in length, com-
monly called the esophagus, or meat-pipe. The walls I
of this canal are made up in part of muecles, by the '
aid of which the food is carried through it. When
empty, its sides lie in contact with each other. At
its lower end a circular muscle guards the opening
into the stomach.

The Stomach. — This is a dilated portion of the 1
alimentary canal, somewhat pear-sliaped in form, and ,
capable of holding from one to two quarts. The walls '
of the stomach, like those of the entii'c digestive canal,
are made up largely of thin layers of muscle, by means
of which it is able to change its size and shape, and
BO to act upon the food as to produce a sort of churn-
ing action. (Fig. 4.)

The Peptic Glands. — The lining membrane
of the stomach, when examined with a microscope,
is found to present multittides of minute openings.

TBK 8TOMACH.

each of which is found, on farther examination, to com-
mnnicate with a narrow tube which ia embedded in the
walls of the Btomach, This little pocket ia lined with
minnte living cells, which, during the digestion of a
meal, are engaged in making a most important digest^
ive fluid, the gastric jaiee, (Fig- 5-)

The Gastric Juice.- — Thia fluid ia intenaely acid.
The acid of the gastric juice ia hydrochloric acid,
probably not a purely chemical acid, bnt aii organic
hydrochloric acid. There ia also preaent
'11 small amount of lactic acid.

The gastric juice contains two digeativi
princijilcs, pepsin and rennin.

The Pylorus. — Eiich end of thi
wtnmach is guarded by a circular muscle.J
That at the lower, or right, end ia kuow
as the pylorus. By means of these mna*]
clea, the openings of the stomach are kepl3
tiglitly closed while the proceas of digest-
ion is going on.
The Small Intestine. — This portion of the ali-
mentary canal is about twcTity fcot in length, reaching,
from the stomach to the large intestine, which it join»>
at the lower right portion of the cavity of the abdo- 1
men. The walla of the inteatiiie are nniscnlar, likej
those of the atomach. Its mucoua liuiug contains'l
many glands, which produce an alkaline digestive flaida
known aa inteatiual juice ; and it is also covered wi&ff
giant cells, which defend the body againat germa. Dor-J
ing digestion, tlio muscular walla of tlie intestinea are |
in constant motion, (Fig. 6.)

oROAMs OF noBenoN. ST '

Fto, 6.— The

THE STOMACH.

The Intestinal Juice. — This, the most compli-
cated of all tlie digestivo juices, ia produced by the ac-
tioa of all the iinmerous and varied* glands fouud in the
tnacoiiB membrane of the intestines. Being composed
thus of the secretions of a ttnmber of different gUnda,
it is of a componnd character, which especially fits it
for its varied fuiictione.

The Absorbents. — The mucous membnme rf 1

the smitll intestine contains numerous folds, and alatfl
peculiar structures for aiding absorption, known at
villi. The villi are hair-like projections of mucous raemTl
brane, which hang out iuto the cavity of the intestine.-.!
Each villus contauis blood-vessels and lymph-channels.
(Fig. 7.)

The Large Intestine, or Colon. — Tins portion J
of the nlimentJiry canul is about five feet in longth,J
and is much larger in diameter tlian the small intea*J

OBOAN8 OP DioEsnow. 29

tine. It begins at the lower right aide of the abdom-
inal cavity, wliere it is joined by the siuall intestine.
From this point tho colon passes upward to the lower
border of the ribs, crosses over to the left side, then
passes down to tho lower left portion of tho abdomen,
and thence backward, finally terminating in the rectum.

The Liver. — I-yiiig chieliy at the right side, jnst
above the lower border of tho ribs, and partly covering
the atomacb, ia the largest gland in the body, the liver.
At the under wide of the liver is a sac, or pouch; known
08 the gall-bladder, in which is stored up the digestive
fluid formed by the liver, called the bile. A short
canal, or duct, connects both the gall-bladder and the
liver with the small intestine at a point a few inches
below tho stomafh.

The Bile. — Human bile is alkalme, somewhat
viscid, and of a golden-brown color when fresh. When
vomited, bile ia often green or yellow, an the result of
changes produced in the atomacli by contact with
acid gastric juice. The bile of the ox is naturally of
greenish color.

A remarkable fact in relation to the strnctnre of
liver ia that it is supplied with two sets of blood-vei
sels. Tho extra Hj'Htem of vessels brings to the livi
the blood from the stomach, iutestinea, and other dig(
tive organs, and eonatitutes the portal circulation,

The Pancreas. — Just behind tlie stomach is'
a long, curiously shaped ghind, known as the pancreas^
which secretes tho pancreatic juice.

The Pancreatic Juice. — This is a fluid much'
like Baliva. It is pnidnccd during the digestion of
meal, and is poured into the small intestine through

THE STOMACH.

duct which joins that from the liver, and with it opens
into the intestinal canal four or five inches below the
stomach. (Fig. 8.)

The pancreatic jmco contains four active principles :
amylopEin, trypsin, steapein, and a milk-curdling fur-
raenl.

In order readily to understand the relation of the
digestive organs and their several digestive fluid.s to
foods, it is necBBsary to briefly consider the qncstion,
What are foods !

FOODS.

Tee body is constaDtly eustaioing loBses in conse-
quence of the vital work performed by its various organs, j
Foods are substiinces which, when introduced into the 1
body, make good its natural wastes and losses, and4
furnish proper material for the repair of its tissues, or j
for carrying on ita vital processes. These require-
ments are met by organizi^d matter, water, and oxygen,
or what may be termed solid, liquid, and gaseous
foods. Of tliGse, the first only is commonly known
as food. Liquid foods are called drinks, all of them |
having water for theii- essential element. Our atteJi-
tion will here be confined to the consideration of organ-
ized foods.

A poison is the opposite of a fotxl. It not only
does not repair wastes ami losses, but interferes with
the vital processes, distm'bing them in such a way as
to occasion sickness and death.

Animal and Vegetable Foods. — Man employs
both animal and vegetable substances as foods. Somo J
nations, particularly the English and the American,
use a large proportion of flesh, and some barbarous
tribes live almost wholly upon it ; but the larger portion
of the human race live chiefly upon vegetable foods.
Many millions of human beings in India and other
parts of Asia never taste flesh food, considering it a sin

to do BO.

Plants the only Food. Producers.^ Plants
alone possess the power to construct living substances

[31]

out of the elements of tbo oarth and the air. Animal
are able to subsiat upon organized Bubatancea only.
ao that a lion, in dining npon an antelope, ia only eat-
ing at aecoud hand the grass and herba which the latter
has eaten ; and a man, in eating roaat beef, ia taking
at aecond hand tlie corn upon which tlie ox was fed.
Food' Elements. — When a chemist examuiea a
loaf of bread or a piece of meat, he finds it to be made
np of various aubstances quite unlike in nature. Theae
food elements each pos-
sess peculiar proper tie a,
and ai'e destined for
(liiTtircut naus in the
body when taken as
fooiil.

Classification of
Food Elements.—

Tlie variona substancea
found in foods may be
included in six claaaes :
1. Starch ; 2. Sugar ;
3, Albumen (all albuminous eubstaucea) ; 4. Fats ;
5. Salts ; G, Indigestible elements.

Starch. — -Tliis element is fnand only in vegetable
foods. In a raw state, atarch is found in small par-
ticles, or granules, each enclosed in a woody envelope.
Starch ia the most abundant of all the food elements.
(Fig. 9.)

Sugar. — Sugar is very unlike stiu-ch in its general
properties, although closely related to it. In the
mysterious chemistry of plant life, the inaoluble, taste-
less starch is converted into this sweet and extremely

soluble snhstanco. Several different kiuils of sugar
occur in nature, tlie most important of which are cane-
sugar, grape-Bugar, and milk-sugar.

Cane-sugar is tbo sweetest of all the sugars, and
is that commonly used as food. It is obtained from
the Bugar-cauc, the sorglium plant, tbo beet root, and
the maple-tree. Grape-sugar is found in most fruits
and in honey. Milk-sugar gives to milk its sweet-
ness. A sugar resembliug grape-sugar, called glucose,
is very extensively maniifaetured chomically, by boil-
ing the starch of corn or potatoes with sulphuric acid.
Glucose ciuinfit be considered a perfect substitute for
natural sugar.

Ali>uni<rii. — The white of an egg is almost pure

albumen. All true fnods contain eiemonls which in

many respects resemble albumen, and serve the same

pnrposes in the body, and bo aje termed albummons

[ elements. For convenience, vro shall apply the term

albumen to any or al! of them. The lean portion of

li ami the casein of milk are forma of animal al-

I bumen. Ail vegetable ftn.ids aUo eontam albumen.

1 Casein, for exampU', is found in peas and beans, as

I well as in milk. One of the most important of all the

I albumens is gluten, which is found in wheat, rye, and

barley.

J'iit't. — Oil, or fat, is found in both animal and

' vegetable foods. Tlio principal animal fats used as

' food are butter, lai-d, suet, and tallow. Vegetable oils

are chiefly derived from oily fruits, as the olive, from

nuts, and from various seeds. A large quantity of

I fat ie found in corn and oats.

Sails. — When a portion of animal or vegetable

TBE BTOMACH.

food ia burned, ihere is left a residue of ashes, made
up of inorganic, oi mineral, elements. These are the
so-called salts of the food. They do not exist in the
food in the form in which they are found in its ashes,
but in an organized form. Grains constitute the most
important source of salts. Wheat, oats, barley, corn,
and rye contain an abundant supply of this element,
as do the potato and most other vegetables. The salt-s
also exist in milk in good propiirtion.

ImlifiettlbU Jilemenis. — All vegetable foods contain
more or less of a woody substance, called cellulose.
Tlie bran of wheat belongs to this class of elements.
Cellulose is not to any extent digestible, but it servei
an im^Kirtant purpose in givmg bulk to the food. The
connective-tissue elements of flesh foods — the ligj-
ineiit^, tendons, etc.^ — are hard to digest, and afford
little or no nourishment.

In addition to the several elements mentioned, all
food substances contain eortain flavoring matters.

Condiments. — A condiment is an article which
possesses little or no food value, but is added to food
for the purpose of inipaiting to it a characteristic flavor.
The condiments most commonly used in this country
are mustard, pepper, ginger, spices, pepper-sauce,
Worcestershire and other hot sauces, and vinegar. All
condiments possess irritating or stimulating qualities.
They stimulate the appetite, and act as whips to the
stomach and other digestive organs, and are for this
reason injurious.

Food Substances.^ None of the several food
elements which wu have been considei'tng are, iu anv

proper sense, t'» be regarded aa food. An animal fed
esclusivelj- upon any one of tbem soon acquires such
a disgust for its food that it will refuse to taste it,
even though starving, and sooner or later dies. Glu-
ten is the only exception to this rule. A true food
contains various elements, which are combined in vary-
ing proportions in different foods. Let us now briefly
notice some of the leading food substances.

Foods of Animal Origin. — Chief among
animal U-Kxis is iniil; the natural diet of most young
animals. Milk contains the different elements of na-
trition in pi'oper pi-oportion, ftud will sustain life for an
indefinite period. The chief albuminous element of
milk ia casein. Tho white color of milk is due to
the fact that it contains a considerable amount of fat,
or oil, in a state of emulsion, or division into minute
drops. By churning, tho little drops are made to
unite, producing butter, Tho ease with which it is
digested renders milk a most suitable food for the
young. It is, indeed, with rare exceptions, a most
wholesome food for persons of all ages.

Chefii^f made from milk by adduig rennet, which
separates the casein and fut from the whey, undergoes
partial decomposition in the process of "curing," and
18 on this account much loss wholesome than fresh
milk. It is difficult to digest, and likely to interfere
with the digestion of other foods. Sometimes a peculiar
fermentation taket^ place in cheese, which produces
a very poisonous substance, known as ty rot ox icon.
Very serious and sometimes fatal illness often results
from tho use of such cheese. This poison is destroyed

3(;

THE STOMACH

by liL^iit. Oil this account cheese ie rendered less
daogerouH hy toasting, whi1» at the same, tirao it ia
made luoi'e digestible.

/iy'j". — All egg contains wiltiiu itself every cle-
ment needed for the euppoit of tlio body, and has
tlie advant;igc, when projiurly cookcKl, of being one of
the most easily digested of foods, and one of very high
. nutritive vuhie. When stale, however, eggs are ex-
ceedingly deleterious, and wholly unfit for food. An
egg usually keeps perfectly fresh not more ihsin three
or four days, when exposed to the oi-dinary summer
temperature. Eggs laid by fowls fed ujmu decaying
meat and other nuwholesomc food, are nufit to eat.

Flesh. ^ — ^The flesh ot the ox, sheep, and hog
ia mitre largely usetl as fmid in this and most other
civilized countries than any other kinds of flesh food.
Mutton is not so well relished aa beef by some, bi
it is nearly as nourishing, and equally as easy to digest,^
Pork contains much fat, and ia difficult to digest^
besides being likely to be diseased, and must be
regarded as an iiifeiior ftiod. The Jews in ancient
times were forbidden to eat the flesh of the hog, and
they still abstain from the use of j)oi-k. The flesh of
deer and other wild game, while uaunlly less tender
than that of stall -fattened animiils, is mom wholesome,
if eaten wlioii fresh, on account of the healthier con-
ditions of life which wild animals usually enjoy. Game.
ia often allowed to become almost putrid before it ii
eaten; such flesh is exceedingly nnwholesome. Yeal,
like the flesh f>f all very young animals, ia difficult
to digest, and cannot be recommended us food.

Fish and Fowl. — The nutritive value of fish

and fowl ie not quite equal to that of beef or mutton; .
but when projwrly cooked, tliey are relislied by most J
pePsoUB, and pussosa eonaiderablo value as foods.

Shell-fish contain very little nutrimeut, although j
6o^e of tliein, oystera in jmrtit-ular, are in vei-y great i
favor aa talile delicafii'S. All aliell-fisli are scavengers, .
however, and are Boniotimea poisonous. Frogs, k)l»- ]
sters, shrimps, sea-crabs, etc., are by many coiieidtTi'd
delicate eating, but cannot bo regarded as really first-
clasa foods. The oyster is easily digested, tlKtugh it
does not possess the power to digest itself, nor to aid
digestion wlicu eaten raw, as many persons suppose.
The oyster is a Beavengcr in its habits ; and when the
beds in which oysters grow are located so as to be reached
by the impure matters carried into the sea by the sew-
ers of a large city, the oysters sometimes become
diseased, and produce scrions illness when eaten. Ty-
phoid foviT has been traced to the use of oysters.

Salted and Smoked Meats. — Most kinds of
flesh foods are preserved by salting. The process of
salting hardens the tissnes, thus rendering them diffi-
cult to digest. Smoked meats and fish are also hard to
digest.

Vegetable Foods. — Vegetable foods are the
original source of tho nutritive elements contained in
flesh foods ; hence we should expect them to fm-nish all
the elements of nutrition, aud in proper proportions.
This is the case with tlio best vegetitble foods. Veg-
etable foods are usually divided into three classes: —

Fniita, O'rni/Di, iind y'eiittahhu. — Fruits comprise
fleshy seeds and seed bearing portions of plants, sucli
as the apple, strawberry, and pium, each of which

THS BTOKACH.

represents a liifferent class of fruits. Melons and
aats are also fruits. Graiite comprise those seeds used
as foods which ure produced by grass-Iiko plants, as
wheat, oats, rye, barley, corn, and rice. Allied to this
class are the edible seeds of pod-boaring plants, the
chief of which are peas, beans, and lentils. Grains
nro the most nourishing of all foods, and contain the
elements of food in tho best proportion. Fruits, grains,
and milk constitute a perfect dietary, and one partic-
ularly suitable for young persons, and for students and
filhor brain-workers.

Those parts of plants used as food, other than seeds
or fruits, such as leaves, stems, roots, buds, and flowers,
are calletl vegetables. The nutritive value of vegetables
19 much less than that of grains. The potato, one of
the most valuable of all vegetables, is three fourths
water, and contains oTily about two per cent, of alba-
miniiua elements. Tlio starch of vegetables is more
difficult to digest than that of grains and fniits, and the
large amount of woody matter enntaincd in moat vege-
tables adds to their indigestibility ; bo that they rntutl
be regarded, in general, as much inferior to fruits s
grains as foods.

Peptogens.— Certain properties and elements of
the food serve to stimuiato tho action- of tlie glands by
"wliich the digestive fluids are produced. For example,
tlio quality of dryness in. the food powerfully excites
the action of the saliva. In experiments condocted
by the author ui the Laboratory of Hygiene of the
Battle Creek Sanitarium (Michigan, V. S. A.) it has ■'
been proved that dry food stimulates tho secretion of '
saliva more than four times as much as moist food.

SOODfi.

Gluten, aibumeii, and other proteid eubatances stimu-
late tho glands of the stomach to jirodnce gastric juice.
The. same is true of dextrin. This fact is of consid- 1
erable interest, as it emphasizes the iuiportance of i
tliorough niaetication of the food. In this way the food ]
has mixed with it an abundant quantity of saliva, hy J
whoso aclinn upon tho starch, tlie dextrin is produced.

The natural flavors of foods stiimilate tlie activity
of all tJie digestive glands ; but condiments, auch as
mustaril, pepper, pepper-sauce, and other substances i
which bui-n and sting as they go down the tliroat, f
do not stimulate tlie secretion of normal digestive I
fluid. They simply provoke resistance and defense, 4
causing an abundant flow of mucus wherewith to pro- 1
tect the mucous membrane from theu- harmful action.

The Natural Diet of Man.— It is pn.bablo
that the diet of tho human family at first consisted
almost wholly of fruits, grains, milk, and a few vegeta-
bles. History informs us that the dietary of the ancient
Egyptians, Assyrians, and the early Greeks and Ro-
mans was of this simple character ; and tho sama
diet is still practically adhei-ctl to by fully t\vo thirds .
of the inhabitants of the ghibe. In dcusely populated
countries, such aa Japan and China, tho diet U nccos-
aarily almost exclusively vegetarian. The peasant class J
of France, Italy, and Spain, and other coutinental
European countries, use fleah so sparingly that it i
be Baid to be a luxury rather than a food with them.
Haman life and healtli can he well maintained upon
vegetable fofnl.

Uses of the Several Food Elements. — The
varioos food elements bci'^'q diHerent purposes in tho

^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^M

^ ^^^^^^^H

^^^^^^^V^^^^^^^H^^^^^^^^^^^I

40 TUB STOMACH.

body. Sugar, etai-ch, and fat make adipose tiBsuo, aud
^v io the form of fat enter into the composition of nearly
^h all the tissnes of the boflj. Tliey are of important
^H service to tlio body in the proilnction of heat and force.
^^V The different forms of albumen nourish especially the 1
^H brain, nerves, muscles, glands, and other highly active
^H tissues of tlie body. TIio salts are largely asod in J
^H nourishing the bones. They are also required by
^^P tlio brain aud the nerves, as vroll as by other tisBQea.
^H The indigestible elements give necessai-y bulk to the

^H DIGESTIBILITY OF

^H Rice 1 00

^H Sago 1 45

^^H Tapiocn 3 00

^^r Barley 2 00

VARIOUS FOODS.

Hr.Ki.

Mutton,- broiled 3 00

Veal, broiled 4 00

Veal, fried 4 30

Fowl, boiled 400

Duck, roasted 4 30

Butter, melted !l 30

Cheese S 30

Soup, marrov-lKine 4 15

Venison, bnilled 1 35

Turkey, ribsuhI 3 30

Turkey, domestic, Ix.il.-d 3 25

Goose, roasted 2 30

Lamb, broiled 3 30

Efffs. hard boiled 3 30

Corn and beana, green . , . 3 4!i
Chicken soup, boiled .... 3 00

Beans, pod, boiled 2 30

Bread, wheaten 3 30

Eggs, fried 3 30

Egps. whipped 1 30

Trout, boiled 1 30

Salmon, salted, bc.iled... 4 00

Apples, Bour and mellow.

Apples, aweet aud mct-

Oysters, stewed 3 30

Beef, lean, rare roasted... 3 00

Beefaleuk, broiled 3 00

Beef, lean, fried 4 00

Beet, salted, boiled 4 15

Parsnipa, biiii^" 3 30

Turnips, flat, boiled 3 30

Potatoes, Irish, bi.iled... 3 30
Potatoes, Irish, baked... 3 30

Pork, salted, fried 4 13

TnansHllKni lummi muE or

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FOon SITBSTANCl

THE DIGESTIVE FLUIDS.

Ih studying the organs of cligestMni, wa buve learned
that there are five digestive fluids ; viz., tho aaliva, the
gastric juice, the bile, the pancreatic Juice, and the
intestinal juice. In the jtreceding chapter it has been
shown that there are five digcstiblo food elements ;
viz., starch, albumen,' fats, sugars, and salts. Lot as '
now consider the use of each digestive fluid in relation '
to the various food elements.

M,uch of the information which has been gained
respecting the action of tho stomach upon the food is
due to the persevering and accurate observations of
Dr. Beaumont, a surgeon in the American army, who,
iu 1823, while stationed in wbtt was then known as
Michigan Territory, was called upon to take charge
of the case of a young Canadian by the name of Alexis
St. Martin, who had been accidently wounded in tlie
side by the discharge of a mnsket loaded with shot, at a
distance of one yard from hia body A portion of flesh
as large as a man's hand was torn away from his side,
leaving large openings into both the stomach and the
chest. The opening communicating with the chest cavity
finally closed up entirely, but the opening into the
stomach remained, Lumediately after hia recovery it
was about two and one half inches in diameter. What-
ever was swallowed passed out tlirongh this opening,
making it necessary for him to wear a pad to close

THE STOMACH.

the opening. In time, nature remedied the difficulty
by growing over the opening, upon the inside, a looae
fold of ntembrune which effectually closed it, yet coald
be easily pushed aside, thiia allowing a full view of the
intcnor of the Btomach.

Oroat and important additions to onr knowledge
of digestion have been mado recently by the use of tli3
atomach-tube, a flexible rubber pipe, by means of
■which digesting food may be removed from the stomach
for chemical examination. The facta tlius learned give
us more positive and definite information respecting
the work of the stomach and the digestive proper-
ties of food tlinn has been previously possessed, and
throw great light npon the hygiene of digestion.

What the Saliva Digests.— A dry crust of
bread, chewed for some minutes, becomes sweet. This
is due to the fact that the saliva contains a peculiar
principle wliich, when brought into contact with boiled
starch, converts it into malt-sugar, or maltose. In act-
ing upon the starch, the saliva produces first soluble
starch, then dextrin, and finally the perfected product,
malt-sugar, or maltose. This ciinversion into sugar
constitutes the digestion of starch. It is essential,
however, that the starch should be cooked, as the
saliva cannot digest raw starch.

What the Gastric Juice Digests. — Pepsin,
one of the active principles of the gastric juice, acts
upon the albuminous elements of the food, such as egg-
albumen, the fibrin of mciit, gluten of grains, casein
of milk, etc. By its action all of these various sub-
stances are converted into one simple substance, known
aa peptone, which is readily absorbed into the blood,

; DIGKSTITE FIX

' while QDdigested alboraen cannot be absorbed to any

great extent, aiid, if absorbed, wonld bo of no nae in

the eystem. The gastria juice preparea the food for

furtJier digestiou by diseolving the substanceB by which

the various elements of the food are hold logothor.

Tho rennet ferment, or roniiiu, of the gastric Juice

coagulates the caeein of milk, forming curds, whieh

I are afterward dissolved in tho gastric juice. The curds

i formed of cow's milk arc much larger und tongher than

l those fonnod of iiiutlifi-'a milk; hence tho difficulty

' experienced Ly many pcrwina in eating cow'a milk,

especially in caises in which the stomach is dilated, and

L consequently weakened to such an extent that it is not

f able to break up the hard curds thus formed. Whon

milk is mixed with oatniual or barley gruel, or other

I farinaceous substances, the curds formed are more brit-

'■ tie in character ; hence the advantage of a<hling oatmeal

or barley water as a diuiinuent for milk in many cases.

I Lime-water has a similar effect, but its long-continued

use is objectiomible.

Carbolic acid, common salt, and numerous other
i- substances are calk-d antiseptics, because they prevent
I fermentation or decay. Tho gastric juice and tlio bile
f also possess this remarkable property. A dog was fed
with putrid meat. On being killed, an hour after, the
L meat, which had been extremely offensive, was appar-
ently perfectly fresli. This property of tho gastric
. juice is exceedingly imporlaut, as it prevents decay
armentation in the stomach before digestion can
take place.

What the Bile Digests. — Like the saliva and
\ tho gastric juice, the bile digests but a single one of

46 THE STOMACP.

the digestible food elements. Its action is wholly upon
the faltjportiona of the food. If oil and water are
shaken together in a bottle, they quickly separate
when the shaking ceaaes, Gnm-water and oil, when
shaken together, form a milky raixtnre in which the oil
and the water do not eepai-ate, and which may bo dilnted
with water the same as milk. The bile acts upon fats
in the samo manner. Such a mixture is called an
emulsion. Under a micmscope, the oil of an emulsion
is seen to be dinded up into very fine drops, or
globules.

What the Pancreatic Juice Digests. — The
pancreatic juice digeats each of the three principal food
elements, — Btarcli, albumen, and fats. Amylopsin
converts starch into sugar, trypsin changes albumen
into peptone, and steapsin makes an emulsion of the
fata. The pancreatic juice thus does the work of all
three of the preceding digestive fluids, — the saliva,
the gastric juice, and the bile.

What the Intestinal Juice Digests. — This
fluid possesses but one characteristic digestive prop-
erty, cane-sugar being ordinarily digestcMl only in the
small intestine, and by the action of the intestinal juice.
Tho intestinal juice also digests starch, albumen, and
fats, and, together with each of the other digestive
fluids, acts upon the Baits of the food.

In herbivorous animals, and to a small extent in .
man, cellulose is digested in the largo intestine.

GENERAL VIEW OF THE DIGESTIVE
PROCESS.

The digestive process begins tLc moment a morBol
of food enters the mouth, and continues throughout 1
the entire lungth of tlio alimentary canal, or until the ^
digestible portions of the food have been completely i
digested.

Mastication. — The fii-st act in the digestive proc-
eee is mastication, or chewing, the purpose of which '
is to crush the food and divide it into small parti-
cleSr BO that the various digestive fl.utds may easily and
promptly come into contact with every part of it.

Salivary Digestion. — The saliva softens the I
food, and thus prepares it f"r the action of the other '
digestive fluids. It also arts upon the starch, convert-
ing a portion of it into sugar.

Deglutition, or Swallowing. — In the act of ^
swallowing, the food does iiot drop down through an I
open tube, but is seized by the mnscles at the back of
the mouth, and is carried dawn into the stomach by
the action of the esophagus muscles.

Stomach Digestion. — Upon receiving the food,
the stomach very soon begins to pour out t!ie gastric
juice, which first makes its appearance in little di-ops,
like beads of sweat upon the face when the perspi-
ration starts. As the quantity increases, the drops '
run together, trickle down the aides of the stomach,
and mingle with the food, The muscular walls of lh% j

TBB BTOUAOH,

stomach contvact npon the food, moving it about with a
sort of churning action, thoroughly mixing the gastric
juice with the food. During thia process both the
openings of the stomach are tightly closed. The gas-
tric jiiic-e softens tlie food, digests albumen, and coagu-
lates milk. The saliva continues its action upon starch
for half an hour aft^r the food reaches tha stomach.
This action of the saliva is highly important to the proc-
ess of digestion. It depends, of course, upon the
thoroughness M'ith which the food is masticated. If
the food is swallowed hastily, it will contain but Httle
saliva, and consequently very little starch will be con-
verted into dextrin and maltose, or sugar ; and the
person will suffer from starch indigestion.

Action of the Pylorus. — After the food has
.remained in the stomach from one to three hours, or
even longer, if the digestion is s!ow or indigestible
foods have been eaten, the contractions of the stomach
become so vigorous that the more fluid portions of the
food are squecKcd out through the pylorus, thus escap-
ing into the intestine. The pylorus docs not exorcise
a species of intelligence in the selection of the food,
as waa once supposed. The increasing acidity of the
contents of the stomach causes its muscular walla to
contract with increasing vigor, until finally those por-
tions of the food which may be less perfectly broken
up, and which the stomach has been unable to digest,
are forced ihriiugh the pylorus.

Intestinal Digestion. — As it leaves the stom-
ach, the mass of partially digested food ia intensely
acid, from the large quantity of gastric juice which it
contains. Intestinal digestion cannot begin

which It I

until the J

DIQES-nVB PHOOESS.

mast» becoming atkalme. The alkaline bile neutralizes
thti gaatric juice, aud renders the digosling mass slightly
alkaline. Tho bilo altio acts npon the fats of the food,
converting them into an emulsion. The pancreatic
juice converts the starch into sugar, digesting both raw *
and cooked starch. It also digests fats and albumen.
The intestinal juice continues the work begun by the i
other digestive fluids, and digeata cane-sugar.

Other Uses of the Digestive Fluids. — In
addition to the usus which have already been men-
tioned, Bt'veral of tho digestive fluids possess other ^
intei-esting properties. The saliva aids the stomach j
by stimulating its gknde to make gastric juice. The J
gastric juice and the bile are excellent antiseptics, by
which the food is preserved from fermentation while-
undergoing digestion. The bile also etimnlates the
movements of the intestines, by which the food is moved
along, and aids absorption. It is a remarkable and
interesting fact tlm a fluid so useful as the bile should
be at the same tiiiB largely composed of waste matters
which are being removed from the body. This is
illustration of the wonderful economy shown by nature '
in her operations.

Peristaltic Action. — The food ie moved along ]
the alimentary canal, from tho stomach downward,
by successive contractions of the muscular walls of the J
intestines, known as periatallie movements, which occur '
with great regularity during digestion.

Absorption.-- The absorption of the food begins
as soon as any portion has been digested. Even in the
mouth and the esophagus a small amount is absorbed.
The entire mucous membrane lining tho digestive canal
ie furnished with a rich supply of blood-vessels, by

TEE STOMACH.

which the greater part of the digested food is absorbed.
Absorption ia greatly aided by a rhythmical coutrac-
tiou of the villi, wliieh is in effect a sort of pumping
action, alternately filling and emptying the lacteui and
venoos absorltenta. The action of tlie diaphragm in
normal breathing also aids absorption by emplving the
blood-vessels of the slfunach and intestines. During
absorption, tlie digested forjd is changed into blood.

The Lacteals.— The walls of the intestines con-
tain certain small vessels, called lacteals, on account
of their white appearaueo after a meal. This appear-
ance is due to the digested fat which they contain, and
which it is their special duty to absorb. The small
lacteal vessels unite to form larger ones, all joining at
last in one large duet about the size of a crow's quill,
called the thoracic duct, which passes upward, and con-
nocte with the large vein which returns the blood from
the left arm. (Fig. 10.)

:VE PKOCESS.

The Portal Vein. — The veins of the Btomat-h, ,
intestiueB, pancreas, and spleen all unite to form c
large vein, called the portal vein. Instead of empty- i
ing, aa do the other veins, into the large vein which goes 1
to the heart, the portal vein conveys its blood to the J
liver, through which it is distributed by a special i
of vessels. Afterward it is gathered up by another
large vein, and carried to the heart. Thus it appears
that all of the food absorbed by the blood-vessels of
the stomach and intes-
tines, constituting the
greater part of what is
digested, is carried to
the liver before entering
the general circulation.
(Fig. 11.)

Liver Digestion. —
The liver not only secretes
a digestive fluid, the bile,
but it acts upon the food
brbught to it by the portal
vein, and regulates the tio, u.

supply of digested food to the general system. It
converts a large share of the grape-sugar and par-
tially digested starch brought to it into livcr-atarch,
commonly termed glycogen, which it stores up in its
tissues. During the interval between the meals, the
liver gradually redigesta the glycogen, reconverting it
into sugar, and thus supplying it to the blood in small
[|uantitics, instead of allowing the entire ann unit formed
in digestion to enter the circulation at onci>. If too
'ge an amount of sugar entered the blood at once, i"

Tim STOMACH,

Hvsttiiii WDuli] b'^ Hiiablo to use it all, and wouli] be
('(iiDpclktl U< gut rid of a coitaidorablo portion throngh
ibe kidne; s.

Tbe remarkable function by which the liver stores
up starch witliiii its tissues is usefully employed as a
means of protecting tho body from various poisons.
When arsenic, mercury, lead, or any other metallic
poison is taken into the etoTnach, any portiou absorbed
is carried to tho liver, which absorbs and retains as
much ns pussiblo of tho poison, aud thus protects the
rest of tho binly. Tho liver treats alcohol and other
narcotics in tho samo inaiUKT ; and it is doubtless for
this reason that tho liver suffers so great damage from
the use of alcoholic driuk», tobacco, and other narcotic
substances.

The Two Doors — The Liver and the Kid-
neys, — One of the im>8t important functions of the
liver is its poiaon-destroying action. Animal aud veg-
etable poisons, whether origiuatiiig outside the body or
within the stomach and iuteatinoa, from the fermenta-
tion aud decomposition of tho food under tho action of
germs, are in large part destroyed by tho liver, or bo
modified as to greatly diminish their injurious proper-
ties. Such portions of these poisons as escape through
the liver must be carried out of the body through tho
kiduoya ; hcitce the work of tho liver has a very im-
portant relation to that of tho kidneys.

If the liver fails to do its work properly, the kidneys
are ov(>rwhelmed with work, and are liable to become
disabled. The liver and the kidneys may be aptly com-
pared to two doors. One of the most essential con-
ditions in health, aud even in life, is that one of these

niQKSTIVK PROCESS.

doore should be constantly slnit, and the other coUBtantly
open. The liver door is, in hL-alth, closed against
the entrance of poisonoiia substancea, while the kidney
door is held vido open, to allow these substances to ,
escape from the body as rapidly as passible. If the i
liver 19 overwhelmed with poisonous subHtancea in *
consequence of errors in diet, it fails to exclude them
all, aiiH they enter the circulation, and so crowd iiiw>n
the kidneys that these organs bocomo obstructed and
disabled ; and the Hvor door thus being open, and the
kidney door partially closed, poisons rapidly accumulate
widiin the body, and the most disastrous effects follow.
It tlius clearly appears why habits tif eating have so
important a relation to every function of the body.

Breathing and Liver Action. — The circu-
lation of the blood through the liver, and hence all the
functions of the liver, are greatly aided by the action
of the chest and diaphragm in breathing. When the
chest wall is lifted outward in the act of inspiration, air
is not only drawn into the chest, but blood is also drawn
toward the heart. Deep breathing is thus a very impor-
tant means of aidmg both the stomach and the liver in '
their work.

Yagaries of Digestion. — The stomachs of cer-
tain persons sceiu to be possessed of marked peculiari-
ties, as the result of which particular articles of food
which agree perfectly well with most people, give rise
in them to very unpleasant symptoms, such as oppres-
sion or bm'uing, headache, aod occasionally slight fever.
These symptoms sometimes occur as the result of eat-
ing strawberries or honey. They are, however, much
more likely to arise from eating lobsters, oysters,

THE MALADIES OF THE MODERN
STOMACH.

OuK forefatliei-a knew comparatively little of the J
panga of iDdigeatioD, or of the coDstitutional maladiea 1
which grow out oE the tissue etarvation and syHtoinic J
poisoning developed from derangement of the digestive j
functions.

. The Causes of Dyspepsia. — An old German '
proverb reads, "Aa a man eatfth, eo is he," This
is perhaps a parody upon a more ancient proverb, "As
a man thinketh, so is he." Putting both sayings to-
gether, we may formulate another etjiially true, "As a
maneateth, so he thinketh," Our bodies are composed
of what we eat; nevertheless, the simple eating of gcMKl
food does not guarantee gofid tissues, a healthy body,
a sound mind, and normal functions. Food must not
only be of proper quality, but it must bo well digesi
Kormal digestion is pei-formed unconsciously.
individual who is conscious of the working of hts j
stomach is suffering with a disordered state of that \
organ. The disorder may be of any degree, from
that indicated by a slight feeling of weight or unoasi-
nees occasioned by taking a small exeesa of food, to I
the most chronic case of indigestion, exhibiting all the
most annoying eymptoma of this formidable diaei
We say forintdahlc disease, not because it is often a 1
fatal malady, but because of its obstinacy, which too
oftCD baffles for years the best efforts of those Buffer-

[55 1

THK STOMACH.

ing from its debilitating effects. In ranst instances,
onfortunatelj, the efforts of the patient and of liis
advisers, though earnest and persevering, are niiuvaii-
ing, becaase not well directed. "With this, as with alt
other diseases, the first step toward recovery lies in
the discovery and removal of the canses of the disease.
Having considered the process of digestion as it occurs
in health, and the conditions required for healthy di-
gestion, we shall now be better able to appreciate the
influence which vai'ious violations of the laws of health
relating to this function may exort upon it.

Healthy digestion depends upon a maintenance of
the following conditions in relation to the stoniaoh : —

1. The secretion of gastric juice in proper quantity
and of good quality.

2. The prompt absorption of the digested food
substances.

3. Normal muscular activity of the stomach, by
which the organ ia emptied of its contents in due sea-
son, or by the end of two or three houi;8 after a meal.

4. The maintenance of an aseptic condition of the
stomach; or, in other words, a condition in wbicii the
stomach is free from microbes, or gi'rms.

Dyspepsia may result from a dtiparture from the
normal standard in relation to one or all of the above
conditions. The gastric juice may be either deficient
or too abundant. Absorption is never too rapid, but
it may be greatly diminished, as in gastric catarrh.

Muscular activity may be either deficient or exces-
sive. If deficient, the food is retained for too long a
time in the stomach, resulting in irritation of the
mucous membrane from too prolonged contact with the

MAIADIXa OF TBI BTOHAOB.

acid gastric juice, and in some cases oven giving rise j
to ulceration. This delay in tho digestive processes |
ulso allows opportunity for the action of germs upon J
the food, tliiiB causing fermentation and pntref action.
Professor Boucbiird, of Pai'is, has shown that if food
is retained in the stomaeh for more than five hours,
putrefactive changes take place. Fermuntation may
begin much sooner tlian tliis. Muscular action may j
be excessive, in which case the food will bo hurried %
oot of the stomach into the intestines before the proc-
ess of gastric digestion is completed, thus giviug rise
to irrittifion in the intestinal canal from contiict with
food which has nf>t beoii properly preparnd fiir the'
processes which occur in this part of tlie digestive
apparatus.

Healthy gastric juice ia capable of keeping the i
stomach in a perfectly aseptic condition ; that :
desti-oying all classes of germs which are likely to J
find entrance to the stomach. If the gastric juice is J
. deficient in quantity or quality, it may fail to do its 1
work as a disinfecting agent, so that germs may '
develop in tlie stomach, and becoming embedded in
the mucus which covers its lining, permanently estab-
lish tht'mselves tliore. Different classes of germs may i
tlms become active in the stomach, either singly or in I
combiiiiition. Such symptoms as acidity, or sour stom-".
acli, lieartburn, coated tongue, a bad taste in th&4
montli, distentioil of tlie stomach, eructations of gaa, f
etc., are due to the presence of germs in the stomach, J
and their action npon tiie food elements. Germs do I
not find lodgment in the stomach when the food isl
digested tlioroughly, and promptly absorbed or passed I

THS STOMACH.

onward into the intestine. Tlie special causes now to
bu meutiouL'd are more or lesa active as agents pro-
ductive of dyspepsia, in proportion as they disturb
the essential conditions of good digestion above
enumerated.

Errors in Diet.^ — There is no room to donbt that
errors in diet, in tlie manner of eating, or in quantity
and (jnality of fotid, are by far the most active causes
of indigestion. By asking a dyspeptic how he eats,
what he eats, and when he eats, it is nsually easy to
discover the cause of liis suffering ; and by inducing
him to fnnu correct habits in tliese three particulars, a
cure will bo effected in nine cases out of ten. In many
and perhaps most cases, however, other adverse influ-
ences of various sorts serve to some extent to compli-
cate the digestive disorder, and to intensify the effects
arisuig directly from tlie causes named ; hence we shall
not confine our investigation of the causes of indiges-
tion to the class of causes mentioned, exclusively, but
sliail also notice those which more remotely operate
in this direction, first, however, calJmg attention to
dietetic errors as the most common and moat powerful
causes of the disease under consideration.

Hasty Hating. — The evils resulting from hasty
eating may be enumerated as follows : — -

1. From deficient mastication, tlie food is not prop-
erly divided, so that the digestive juices cannot gain
access to its various elements.

'2. By being retained in the mouth too short a
time, an insufBeient amount of saliva is mingled with it,
so that salivary digestion cannot be properly performed.
Aa the saliva is also a stimulus to the secretion of

HAUDIE8 OF THR BTOU&CH.

gastric juice, Btomnch digeation must necessarily be
imperfect.

3. Again, if the food enters tlie Btomach in a coarBSt,
onmasticated state, it umj act aa a meclianical irritant tO'
the delicate lining i>f tlie stamacli, and thus occasii
congestion and giistric catarrh, one of the most con
disorders of the stomach, and one which is often
obstinate in its natui'i'.

The heat remedy for tl^u habit of liaaty mastication
ia the use of dry food. The impoitance of tJiia is well
ehowD by a series of experiments conducted by the
author for the purpoao of determining the amount of
saliva produced in masticating dry food as compared
with moist and h'quid foodw. The remdts wore as
follows : — -

A piece iif paraffin chewed for five minutes pro-
duced two thirdp of an ounce of flaliva.

One ounce of graunec, n dry fiK>d prepared from
wheat, increased in woight ti» two oonces. The addi-
tion of pepper and salt to tlie graungo slightly decreased
the amount of saliva produced. The addition of vine-
gar still further diminished the secretion.

One ounce of moist bread chewed for five minutes
caused the production of one ounce of saliva.

One ounce of raw apple produced one and one-
foorth ounces.

An ouuce of water produced but one tenth of aa
ounce of saliva, or about one sixth as much as a pieoe
of paraffin, and one tliirtietli as much as an ounce (tf
granose.

One ounce of milk was slightly more active in pro-
ducing saliva than the same amoonc of water.

THE STOMACH.

An ounce of pea soap chewed for five nminteB pro-
duced twico us much saliva as did water, bnt only one
third as mnch as i>araffiii, and one tentli as mach as
grauose.

The nse of "slops," so common in the United
States, and to a great extent also in other eonntries,
is one of the ino-it serioua of dietetic errors. The
American eata in a hurry, rinses down his food with
copious draughts of tea, coffee, iced water, iced milk,
or iced tea ; and in cimsequence the salivary glands are
not stimulated to proper activity, so that the amount
of saliva produced is altogetlier inadequate to digest
the starchy elements of fiiud in the acid medium of
the etomacb coutents, and the small amount produced is
so diluted that its efficiency is greatly impaired. What
wonder that starch indigestion is coming to be an
almost universal complaint, as shown by acidity,
eructations of gas, flatulence, and a great variety of
stomach disturbances, to escape from which multi-
tudes are continually swallowing quantities of magnesia,
soda, neutralizing cordials, and alkaline mineral wa-
ters of various sorts, together with malt extracts and
other digestantsl

The inability to digest starch is doubtless one of
tlie great causes of the inordinate consumption of beef
and other animal products to which the English-speak-
iitg race has come to bo addicted, as a method of
escaping the pangs of starch indigestion.

The abundant provision made iii the human body
for the digestion of starch, — first, the saliva ; second,
the bile and pancreatic juice ; third, the intestinal
juice ; and finally, the liver,^ is evidence that nature

MALADIES OF THE STOMACn.

intended man to subsist largely upou fariiiacenue footle.
The arguments of the "natnral food" advo<MteB,
who insist that man should lire upon fruits and nuts,
are based, not upon phyeioJogical facts, but upon the
morbid experiences of the disciples of tliis doctrine,
Tlie writer had an opportunity, a year or two ago, to
examine tlic stomach fluid of one of the most earnest
and stalwart adTocatea of the fruit-and-nut diet, and
the stomach was found greatly dilated, and almost com-
pletely inert.

1 havt; cured many bcoi-os of chronic and very
obstinate cases of dyspepsia by simply requiring the
patient to subsist upon a dry diet, whereby he was
compelled to tlioroughly masticate his food. A fa-
vorite prescription with the writer, which is applicable
in most cases of indigestion, is one or two ouncoa of
dry granose eaten at the beginning of each meal.
This introdnces into the stomach an abundant quantity
of saliva, — probably from four to six ounces in most
caacs, — and insures efficient starch digestion,

Tlio dextrin and maltose produced by the action
of the saliva upon the starch are exactly what the
stomach needs to Htimulato it to healthful activity,
whereby a proper quantity' and quality of gastric juice
will be produce«l.

Diseased Teeth. — Ulceration of the teeth is
a very common ailment. Decay of a tooth is exactly
analogous to ulceration in other parts of the body.
This destructive action upon the toelh is due to the
presence of germs in the mouth, which produce chem-
ical substances of such a nature as to dissolve the

enainel, aiid thns expose tlie inner portion of the teeth
to the action of destructive microbes.

Defective teeth, by interfering with the complete
and thorough mastication of food, seriously impair
the digestion. On the other hand, impairment of di-
gestion, with its consequent perversion of the secre-
tions, is a very common cause of decay in the teeth.
Many persons suffering from disorders of digestion can-
not hope to recover without giving attention to the
teeth, that being necessary as the first step toward
reforming the condition of the stomach. If ptissible,
the natural teeth should bo preserved by tilling when
decayed, and by such olLer measurfH as any good
dentist will recommend.

The microbes hai"bored by decaying teeth are swept
into the stomach in drinking or eating, and there set
up fermentative and putrefactive processes, whereby
the food elements arc eonvei-ted into poisonous sub-
stances. Some of these poisons are possessed of such
strong odors as to taint the breath. Decaying teeth
may also be the means of introducing into the body
such destructive microbes as the germs of consump-
tion, and others giving rise to serious and even fatal
disease.

Decay of the teeth is generally the result of lack of
use and of cleanliness. By the use of dry food as pre-
viously stated, the teeth are polished and tept free
from the colonics of germs which settle upon them
when they are not scoured by attrition of hard sub-
stances. Meat eating is especially favorable to tlie
destruction of the teeth. The small particles of meat

MAI^DIBS OF TBB FTOtUCB.

which collect between the teeth eocaorage the derelup-
meDt of germs of the moet detftmctiTe t^iancter. Pret-,
ervation of the teeth requires babiloal tad
cleaDliaess. They shonld be thoroagblT
and after each meal, — before the meal tor tbe
pose of protecting the Btomach from the germs
occumnlate in the mouth from the air. utd lodge
the teeth ; and after tbe meal for tbe purpose oi mmor-
ing every particle of food, bo that tbe grfnrth and devel-
opment of germs which snbsist npon remnants of food
left behind in the month, sball not be encooraged.

It it! wi'11 to employ Bome mailable antiseptic a» well
us a cleansing agent for tbe teeth, but many harmful
substances are recommended for this use. Tbe writer
lias had an antiseptic dentifrice prepared, tbe basis of
which is an extract of tlie famons soap-tree of South
America, and cinnamon oil. The firxt of tbeflo ingredi-
ents is as cleansing aa soap, and avoids the impurities
and chemical substances found in it. Oil of cinnamon
is one of tbe best antiseptics, preventing the growth of
germs even when not used in sufficient fjoanlity actually
to destroy them.

Tbe rapid decay of the teeth in civilized countries,
which is principally due to the excessive am of meats
and of soft foods, as mu!<he!«, soups, bouillons, etc.,
has in our time led to a full realization of the dream of
Giles Corey, who was put to death for witchcraft at
Balem nearly two hundred years ago, and who wrote : —

"I B«w u man pull all his teeth,
It look him but u miiiuii; :
He op'd his Bioulh and put Ihem butk;
I thought 'u deuce whb in It."

THK l^TOMAOH.

The tartar which sometimes accumulates upon
the teeth is due to the action of germs. Tartar should
never be allowed to remain, — indeed, the teeth should
be so often and so carefully cleansed as to prevent the
slightest accumulation of tailar. When allowed to grow
and remain, tartar separates the gum from the teeth,
and produces an unhealthy state which often causes the
loss of the teeth. Fig, 13 shows human teeth on which
are formations of tartar. In Fig. 13 arc shown the some
teeth with the taitai- removed. The teeth of Orientals,
, and in fact of nearly all primitive people, are

generally remarkably eoiuid, because of their simpler
diet and small use of meat.

If the natural teeth cannot be saved and made
serviceable, they should bo replaced by artificial ones.
No one can hope to preserve good digestion while
munching food with toothless gums, or subsistuig on a
dietary that does not require the use of teeth.

Drinking at Meals. — In addition to the evils
which it occasions directly, hasty eating induces the
drinking of large quantities of hot or cold liquids to
wash t!ie food into the stomach. Thus two evils are
associated. Too much liquid of any kind is prejudicial
to digestion, because it delays the action of the gastric

MAI.ADIB9 OF THE BTOHACH.

«^ 1

I
I

juice, w<iBkons its digestive qualities, and overtasliB the
absorbeuta. In case the fluid is hot, it relaxes and
weakenB the stomach. If it is cold, it checks digestion
by cooling the contents of the stomach to a degree at ,
which digestion cannot proceed. Few people are aware 1
how serious a disturbance even a small quantity of cold i
water, iced cream, or other i^old substance, will create i
when taken into a stomach where food is undergoing 1
digestion. This procoss cannot be carried on at a tem-
perature less than that of the body, or about 100* F.
Dr. Beaumont observed that when Alexia St. Martin
drank a glassful of water at the usual temperature of
freshly drawn well-water, tiie temperature of the food i
undergoing digestion fell iuimediatcly to 70°, and did
not regain the proper temperature until after the lapse
of more than half &u hour.

Of coarse the eating of very cold food must have a
similar effect, making digestion very tardy and alow.
If any drink at all is taken, it should be a few minutes
before eating, so as to allow time for absorption before
digestion begins. If the meal is mostly composed of
dry foods, a few sips of warm or moderately hot water .
will be beneficial rather than otiiorwise, taken either at '
the beginning of the meal or at its close. The habit
of drinking during tho meal should be discontinued
wholly, and especially by those whose digestive powers
are weak. If the diet is of proper quality, and the
food is well masticated, there will be little inclination
to eat too much. When tho food is rendered fiery with
spices and stimulating condiments, it is no wonder that
there is an imperious demand for water or liquid of
some kind to allay the irritation.

Eating too Frequently. — One of the moat per-
nicicns customs of inoclern life is tliat of frequent meals.
Tliis habit is seen in its extreme development in Eng-
land, five meals a day, including lunches, being there
considered none ti^io many. The idea seems to prevail
that the stomacU must never be allowed to become
empty under any circam stances. In this country, three
meals a day is the general custom, though more are
sometimes taken.

Healthy digestion requiics at least five or six honrs,
and one or two hours for rest before another meal is
taken. This makes six hours necessary for the dis-
posal of each meal. If ordinary food is taken at
shorter inter\'alB than this, the stomach must suffer dis-
turbanco sooner or later, since it will be allowed no
time for rest. Again, if a meal is taken before the
preceding meal lias been digested and passed from the
stomach, the portion remauiing, from its long exposure
to the influence of warmth and moisture, is likely to un-
dergo fermentation, in spite of the preserving influence
of the gastric juice. Thus the whole mass of food is
rendered less fit for the nutrition of the body, and what
is still more serious, the etomach is liable to suffer
permanent injury from the acids developed.

Too frequent eating occasions too long contact of
the acid contents of the stomach with the gastric juice,
which produces catarrh and ultimately ulceration of that
organ, Fi'ef|nent eatiug is often resorted to as a relief
from what is commonly termed faintness, or an "all
gone" feeling in the stomach. The fact that eatiug
gives a respite from this sensation is taken as good
evidence that it is the proper remedy ; but. at the best.

M4LADIE8 OK THE BTOMACH.

mlj temporary relief is obtained, and tbut at the ex-
pense of aggravating the difficulty. Food aEEorda relief
Binipty by separating the irritated mucous surfaces of
the stomach, and diluting its acid fluid. The proper
remedies for these unpleasant symptoms are given elsu-
where in this work.

Eating betvreen Meals. — This ia a gross breach
of the requirements of good digestion. The habit many
have of eating fruit, confeetionery, nuts, sweetmeats,
etc., between meals, is a certain cause of dyspepsia.
No stomach can long endure such usage. Those who
indulge in this manner usually complain of a poor appe-
tite, and wonder why they have no relish for their food,
strangely overlooking the real cause, and utterly disre-
garding one of the plainest laws of nature.

This harmful practice is often begun in early child-
hood. Indeed, it is too often cultivated by mothers and
the would-be friends of little ones, who seek to please
aud gratify thorn by presents of confectionery and other
tidbits of various sorts. Under such indulgence, it is
not singular that so many thousands of children annu-
ally fall victims to stomach and intestinal diseases of
various forms. In great numbers of cases, early indis-.
cretions of this kind are the real cause of fully developed
dyspepsia in later years. What a sad thought that
the lives of such persons have been modified in their
usefulness, and their whole characters more or less
depraved, by the morbid influence of disordered di-
gestion.

Irregularity of Meals. — Another cause of dys-
pepsia, which is cloHely related to the ones just men-
tioned, is irregularity respecting the time of meals.

Tht human system seems to form habits, and to be iti a
great tipgree dependent upon the performance of its
functions in accordance with the habits formod. In
respect to digestion this is especially observable. If a
meal is taken at a regular hour, the stomach becomes
accustomod to receiving food at that hour, and is pre-
pared for it. If meals are eaten irregularly, the stom-
ach is taken by surprise, so to speak, and is never in
a proper state of readiness for the prompt and perfect
performaiice of its work. The habit which many pro-
fessional and business men have of allowing their
biieiness to intrude npoTi their meal hours, frequently
either wholly depriving thom of a meal or obliging them
to take it an hour or two later than tlie usual time,
ultimately iindormines the best digestion. The hour for
meals should be considered a saered one, not to be
intruded upon except under some unusual circumstance.
Eating is a matter of too momentous importance to be
interrupted or delayed by matters of ordinary business
or convenience.

The Lahit of reguhirity in eating should be culti-
vated early in life. Chihlrcn should bo taught to be
regular at ihcir meals, and to take nothing between
meals. This rule applies to infants as well as to older
children. The practice of feeding tlie little one every
time it cries, results in most serious injury to its weak
digestive organs. An infant's stomach, though it needs
food at more frequent intervals than an adult's, — every
two to four hours, according to its age, — requires the
sanie regularity which is essential to the maintenance
of healthy digestifwi in older persons. The irregularity
usually practiced is undoubtedly one of the greatest

MALADIES OF THE StOMACn.

causes of the large number of deaths among

from disorders of the digestive organs shown bj oaira

mortuary recoi-ds.

Tlio action of the digestive organs, like that of alt
other organs of the body, is rhythmical. The discharge
of the alimentary residue, whicU constitutes the fecal
matters, normally occurs after the first meal of the day.
It is the result of tlie peristaltic movemenls set up by
the introduction of food into the stomach. By this
increased activity of the alimentary canal the fecal
ters resting in the upper portion of the colon are movi
downward into the rectum, thereby provoking a de,
for evacuation of the bowt-le. By this moans, the
tivities set up by each meal move the contents of
intestine to their appropriate station, resulting, in healthy
persons, in the disciiargo of the alimentary residue from
the body at a stated hour each day. If a meal is
omitted, or if meals are taken at irregular hours, this
rhythmical a(rtion is broken np, and constipation is the
natural result.

It thus appears that eating at too frequent intervals
is not the only evil in the way of irregularity in eat-
ing. It is far better, however, to omit a meal than to
introduce into the stomach a new supply of food before
tliat already contained in it has been properly digested,
and the organ given an opportunity for rest.

The Proper Number of Meals. — The number
of meals which should be taken by a person in health
depends somewhat upon the habits of the individual,
bis occupation, the number of tours he labors, etc.
There is good reason to believe that for a large pro-
portion of those wlio now take three to five meals a

(0 THB STUMAC-H.

day, two would be mnch better. According to Hippoc-
rates, tlie ancient Greeks ale but two meals a day.
The same was true of iho ancient Hebrews and Per-
sians. This is also the cnstora of the natives of India,
of South America, and of many semi-civilized nations.
Among savage tribes, one meal a day is the prevailing
custom. The Eskimo walrns banter sets ont in his kijaJc
un a day's hunt at the break of day, but eats nothing
until after he returns with his prey, jest before sunset.

The modern frequency of meals is the outgrowth
of a gi-adual losing sight of the true pur[)08e of tlio
eating of fond, and of regarding the gratification of
the palate, instead of the nourishment of the body, tlie
chief object to be attained. That the system can be
well uouriBhed upon two meals a day is beyond contro-
versy, seeing that not only did our vigorous fore-
fatliers require no more, but that hundreds of persons
in modern times have adopted the same custom without
injury, and with most decided benefit to themselves.
Students, teachers, clergj'men, lawyers, ajid other lit-
erary and professional men are especially benefited by
this plan. The author has followed the plan for more
than thirty years, aud with great satisfaction The
special advantages gained by it are : 1. The stomach
is allowed a proper interval for rest. 2. Bleep is much
more recuperative when tlie stomach is allowed to i-est
with the balance of the body. 3. Uigestiou cannot
be well performed during sleep,

DujardLn-Beaumetz, an eminent French physician,
Bouchard, and other well-known European authorities,
insist that seven hours is the proper length of time to
be allowed for the digestion of each meal. If this

plan is followed, aeveu hours being allotted to llie di-
gestion of each meal, and the proper length of time
allowed to elapse before going to sleep after the last
meal, it will be found impossible to make any arrange-
ment by which oppoitimity can be secured for the nec-
essary eight hoHTs' sleep at night. Not more than two
meale can be taken when a person complies with all the
laws of health.

If more than two nieala are suited to auy class, it
ta those who are engaged for twelve or more hours per
day in severe mental and physical labor. Such persons
are better prepared to digest a third meal than those
whose occupation is mental or aedenfaiy, and they may
at least take it with less detriment, though a third meal
is not needed, even for such, provided the two meals
are taken at suitable hours. For many years, the prac-
tice at the Battle Creek Sauitarium has been to furnish
its guests with two regular meals daily, the fii-st at S
A. M,, the second at 3 p. w. ITie employees, num-
bering at the present writing something more than six
hundred, are also furnished with but two meals, at G
A. u. and 1 :30 p. w. The universal testimony of all
who have become acenstonied to tlicae hours for eating
is that more work and better work can he accomplished
than when three meals are taken. In cases requiring
more than two meals, as when liquid food or only
small quantities of food, can bo taken at a time, we
find it wise to supply two minor meals, at V2 h.
and 7 p. u.

Late Suppers and Si.\. o'clock Dinners. —
Eating late at night, when the muscular and nervous
systema ai-e exhausted by the labor of the day, and

I'l THE STOMACH.

retiring to rest soon after, is one of the most positive
dyspepsia-producing habits of modem times. A sleep-
ing stomach ia a slow one. Secretion must of necessity
be deficient in both quantity and quality, owing to the
exhausted condition of the system ; and with the further
obstacle afforded to prompt digestion by the slowing of
the vital operations during sleep, it is almost impossible
that there should be other than disturbed digestion, and
restless sleep in consequence. It is under these cir-
cumstances tliat people often suffer with obstinate in-
somnia, bad dreams, nightmare, and similar troubles,
from which they arise in the morning unrofreshed anil
unrecuperated by nature's sweet restorer, the work of
assimilation, by which repair takes place, having been
prevented by the disturbed condition of the nerves.

No food ought to be taken within four hours of retir-
ing. This will allow the stomach time to get the work of
digestion foi-warded sufficiently to enable it to be carried
on to completion wilhout disturbance of the rest of the
economy. If a third meal is taken, it should be very
light, preferably consisting of ri]>o fruit and simple
preparations of grains. The costum which prevails in
many of the larger cities, of making dinner the last
meal of the day, eating of foods the most hearty and
difficult of digestion as late as six or even eight o'clock,
is one that ought to bo discountenanced by physicians.
It should be tolerated only by those who convert night
into day by late hours of work or recreation, not retir-
ing until near midnight. But in such cases a double
reform ia needed, and so there can be no apology
offered for this reprehensible practice, on any physio-
logical grounds.

MAL&DISB OF THB STOMACH.

It shouhi be romembered tliat the process of dig
tion is not complete when the food leaves the 8tomach.J
Recent observations made upon a man having a fists- 1
louB opening at the jnnctiou of the small intestine with
the colon, have shown that fourteen hours elapse from
the time food is eaten nutil it enters the colon,
when the process of digestion is completed, the colon
being chieilj a reservoir where the digested food is
retained for absorption.

Eating when Exhausted. — This is a mostj
certain cause of deraugenient of digestion, and i
which a very large number of cases of dyspepsia may^
be traced. The third meal of the day is almost alwayfH
taJcen when the system is exhausted with the day'd
labor. The whole body is tired, the stomach as well as '
other parts of the orgauism. The idea that by the tak-
ing of food the stomach or any otlier part of the system
will be strengthened, is a mistake. An eminent writer
on indigestion says very truthfully, "A tired stomach
is a weak stomach." When the stomach feels "weak
and faint," rest is what is demanded, and is the only j
thing that will do it good ; yet many people insist onj
potting more fofid into it, thus compelling it to workl
when it ought to bo allowed to remain inactive nntS,'l
rested. The arm wearies hy constant exercise, and e
docs the stomach, which, like the arm, is active throug]
its muscular structure. Both secretion and muscularl
activity are greatly lessened in a tired stomach, aodl
the habitual disregard of this fact eannot but be disaa-i
trous to the best digestion.

Violent exercise eilhcr just before or just after eat' J
ing is a hindrance to godd digestion. When the exBr--r

<-isu Ih taken just before the meal, thu Btomach is left
too tii-ed to do its work properly ; and when taken im-
mediately after eating, the vital energies are diverted to
other parte, and the stomach is tlius robbed of its nee-
eeeary share. An English physiologist performed an
experiment which well illustrates the truth of this posi-
tion. Having fed a dag his usual allowance of meat
one morning, he took him out upon a fox hunt, and
kept him racing over the country until night, wheu,
having killed the animal, he examined his stomach at
once, and found tho meat in the same condition in
which it had entered the stomach, no digestion having
taken place. In another dog, fed with the same kind
of food, but left quiet at home, digestion was found to
be complete.

The hurry and press of business among Americans
is allowed to override every consideration of health.
It seems never to enter the mind of the average busi-
uesB mau that any time is required for digestion.
Rushing to his dinner from the plow, the workshop, or
the couuting-rooni, he swallows his food with all pos-
sible dispatch, and hurries back to his work again,
begrudging every moment spent in meeting the re-
quirements of nature. Many years ago it was custom-
ary in Edinburgh to suspend all business for two hours
in the middle of the day, so as to allow ample time for
meals. A similar custom once prevailed in Switzer-
land ; but probably such a sensible custom is now con-
sidered too old-fashioned to be tolerated.

It should be remarked that severe mental labor im-
mediately before or after and especially during meals,
is even more injurious than physical employment. The

MALADIES OF THE BTOMACH,

T5fl

habit many busineaa men have of anxiously Bcanning^
the nevfapapers during their nioals, and wliile going to
and from their places of bnsint'aa, ia a ba<l one. At

t a full hour should be taken for the midday meal ;
and if an hour's rest can be aecured before eating, im-|
proved digestion will well repay t!io time spent infl
reinforcing the vital energies. Foi- persona of weakfl
digestion, the rest before eating is ahrmBt indispon-T
sable.

Recent experiments have shown that the maacnlw
strength is increased very soon after eating. Tliia muatf
be dne to the digestion anJ absorptinn of the atarch,]
whereby the muscles are furnished a fivsb supply of]
glycogen, wbicli is their source of energy. It is, lliere-fl
fore, admissable that a very snmll amount of fooda
be taken by an exhausted person, but it should be of i
kind which ie easily digested, and tho quantity should I
be very small. Nitrogenous fi»od, such as meat andJ
egga, ia eapocially detrimental to a person ia this coa^l
dition. Tbin, well-boiled gruel or rice watijr, a littleJ
rice, a crust of bread well chewed, a cup of vegetableJ
broth, a bunch of grapes, an orange, or a bit of ripel
fruit of some other kind, are most auitable for ttiis'j
purpose.

Sleeping after Meals. — While rest from i
customed exerciae after eating is important, it ehoulct
be noted that sleep at this time is oqually as bad as vigor-fl
OUB exerciae of either mind or body. Good dig
cannot take place daring sleep. While it is true thatl
digestion is an involuntary act, it should bo recollected j
that it is dependent upon the activity of the nervoos J
system for its proper performance. The same nerve

7ti

THE STOMAi

which secures activity of the respiratory organs, — the
pnenmogastric,— controls the muscular activity of the
fitomach and the iutestiueB. During sleep, from the
lessening of nervous activity, both the respiration and
the circulation are greatly lessened in vigor. It is but
reasonable to auppuse that the activity of the digestive
organs is docreast^d at the same time, being controlled
by the same nerves. Actual experiment shows this to
be true. Most people who lie down and sleep an hour
or two Boon after taking food, awake feeling anj-tluiig but
refreshed. The stiBpeoBion of the process to a consid-
erable degree during sleep causes ini[>erfect digCHtion,
with its numenius nnpieaeant symptoms. In the case
of old people, it may soinetiines be beneficial, or at
least not harmful, to secnro a few minutes' sleep after
eating, before digestion is well begun ; but it must not
bo long continued.

In order to secure the beat conditions for digestion
after eating, an iudividua,! should take gentle exercise
of some kind, as walking, or carriage or horseback rid-
ing. While violent exertion seriously interrupts the
digestive process, a moderate degree of physical exer-
cise facilitati!S it by increasing the activity of the glands
by which the gastric juice is formed. It is probable
that gentle exercise also encourages digestion by stim-
ulating the movements of the stomach.

Too Many Varieties of Food. — Many dys-
pepsias aj-ise from the eating of too many kinds of food
at the same meal, another growing custom of modern
times which deserves to bo severely condemned. At
great dinners in honor of distinguished personages,
when friends are to be entertained, and in the majority

MALADIES OF THK STOMACH.

of well-to-do families aa a guiieral cnistoin, the eai
are tempted to gluttony by having presented to their ^
palates a great variety of complicated dishes. On thef
occasion of the giving of a great dinner, more than a
hundred dishes are souietimea served in successive
courses. Such gormandizing soon breaks down the
most vigorous digestive organs, since it adds to the
labor of digesting food whidi is improperly cooked, a
larger variety than the digestive juices are capable of
bringing into a fit state for absorption.

Food Combinations. — Carefnl experiments have'J
shown very clearly that different cInBBes of food require J
a particular qnality of digestive juices fur tlii'ir diges- 1
tion. For instance, a gastric juice that will digest ani-
mal food the best, is inferior for the digestion of vege-
table food, and vice versa. The obvions conclusion to
be drawn from this fact is that the simjiler the dietary,
the mora perfectly will the digeutivo process be per-
formed. For persona whoso digestion is naturally
weak this is a matter of especial importance. The fol-
lowing table represents the best and worst f<^od combi-
natioDB : —

OOOD COMBINATIONS.

Grulns untl Fruits. Grains und Milk.

OrNlDS and Meat, or Eggs. Oruiiis unit Vi'tn^tablc^.

FAIR COMBISATIONB,

Fruils and Vsgetables

Those foods

agree

Milk aQd Meul.
best whoBO chief constituent ele-

meuta are digested by the same fluid, in the

TUK STOMACH.

of the alimentary canal, and in about the same length
of time, TegetablcB contain a great amount of coarse,
woody Btmctures, which are retained in the stomach a
long time before they are sufficiently broken «p to be
easily digested in the intestines. Frnits, on the other
hand, remain but a short time in the stomach. The
large amunnt of Baccharine matter wliich fruits contain,
makea them likely to sot up fermentation in the stom-
ach, if retained too long. Acid fruits are also likely
to delay starch digestion. This ia another reason for
their interference with vegetables, the starch of which
ia rather more difficult of digestion than that of grains.

Milk and vegetables are likely to disagree, for the
reason that milk, when taken by itself, ia retained in
the stomach bnt a short time, its digestion being carried
on chieHy in the small intestine. Milk and meat are a
bad combination for the same reason. Meat requires
long digestion in the stomach, whereas milk, when
taken by itself, is quickly passed on, to be digested by
the pancreatic juice. When taken with meat or vege-
tables, milk, being long retained in the atomach, under-
goes fermentation, resulting in aour stomach, bilious-
ness, and various other unpleasant symptoma.

If the hill of fare taken at a single meal were eon-
fined to three or four articles of food, there would be
fewer dyspeptics scanning the newspapers for aome
patent nostrum to "aid digestion."

Hot or Cold Bathing after Meals.— Especial
mention should be made of the injury to the digestive
organs quite certain to result from taking either a hot
or a cold bath Bi>on after eating. Few people nro aware
of the danger of laying the foundation for years of die-

MALADIES OF THS 9T0UACH.

T9l

comfort in this way. If the bath be a hot one, the stom-
ach will be deprived of the blood necessary to sup
the rapid secretion of gastric juice for the digestion of J
the food, by its being drawn to the surface of the body <
by the sudden relaxation of the capillaries and small •!
vessels of the skin. A cold bath, on the other hand,
or any sudden exposure to cold, may, by causing con-
traction of the blood-vessels of the surface of the body,
cause sudden congestion of tho stomach, which is
equally fata! to good digestion. Very nearly the same I
danger exists from bathing just before a meal.

The practice very common among boys and young
men, of going into the water in the eummer-time, re-
gardless of the state of the digestion or other conditions
of the body, is a bad one. With many it ia a very
usual practice two or three times a week, if not oftener,
to go into the water immediately after the evening
meal, not even allowing time for the work of digestion
to become established. No bath involving any con-
siderable portion of the body should be taken within
two hours after a meal, except by the advice of a '
physician.

Errors in Quantity of Food. — If errors in thftl
manner of taking food are active causes of indigestion^ /
mistakes in quantify are still more potent in this diroc- j
tion. It should bo noted, however, that eirors of this j
class are very closely connected with others in the n
ner of eating, and in the quality of foixl taken. It is]
generally true with physical as well as moral transgres-^
sion, that one bad liabit invites another ; and especially 1
is this the case iu reference to diHetic errors. A per- 1
son who eats too fast is likely to eat more than is neo--a

THE STOMACH,

essary ; and the same Is true if too large a variety of
food i» partaken of, or food rendered excitiug and
Btimulating by seasoning with irritating condiments.

Overmt ill r/.^ Intemperance in eating is, in the
opinion of the writer, responsible for a greater anionnt
of evil in tho world than ia intemperance in drink. In-
deed, it can be clearly shown that intemperate eating
is, in the first place, one of the most potent causes of
intemperance in drink, and alao that it is one of the
obetaeles in the way- of the reformation of those who
have become the victims of alcoholic intemperance.

The extent to which overeating is sometiraes carried
is almost incredible. Travelers in the Arctic regions
report that it is not an uncommon thing for a Laplander
or an Eskimo to devour a large portion of a small sheep
at a single mual. A German authority reports the case
of a hysterical girl eighteen years of age, who ate regu-
larly twelve times a day, consuming from twenty-four
to twenty-six pounds of food. Id another case a woman
who was seized with a peculiar form of morbid appe-
tite, known as bulimia, in forty-five minntes ate twenty-
three eggs, and drank three pints of milk and two pints
of wine.

But if we may believe the statements of historians,
gluttony is by no means a modern vice. Indaed, there
is quite gO(jd ground for concluding that overeating,
while a very general fault, is rarely, if ever, at IcMt
among civilized nations, carried to the enormous excess
in which some of the luxurious Koman emperors in-
dulged.

The evil consequences of excess in eating are at first
simply imperfect digestion, the overtaxed organs being

MALADIKS OF TUB STOMACH.

nimble to accoraplisli tho complete digestion of the
alimentary mass. In conseiinence of the delay wbicli
occurs, changes take place by which acids are deveh.i]>ed
that, irritate the mucous niembrauo, togetlicr witli
gases by which the stomach is distended, and its mus-
calar walls weakened and partially paralyzed. In
course of time, inflammation of the gastric membrane
is developed, and permanent dilatation of the stomach

This condition is one which cannot nsually be en-
th-ely cured, and which gives rise to a groat variety of
ailments in addition to tlio discomforts connoGted di-
rectly with the stomach itself. These are inoi-e fnlly
ptiinted out elsewhere. Dilatation of the stomach often
originates very early in life. Tho writer lias found the
organ dilated to more than its normal size in children
scarcely a dozen years of age, and in many cases has
been able to trace tliie condition found in adults back
to early childhood.

An individual who overeats will at firwt be likely
to accumulate flesh tjuito rapidly ; but very soon the
digestion becomes so much disturbed that no gain takes
place, and, indeed, tho patient not infrequently becomes
considerably emaciated even while daily taking large
qnantiCies of food. Wlien tho opposite is the case, the
blood is filled with crude, imperfectly elaborated mate-
rial, which, when absorbed, fills the system with poi-
sonous substances. At first the liver is able to exclude
these to a considerable extent, but after a time the en-
ergy of this patient organ is entirely exhausted, and
the whole system suffers in consequence. Biliousness
and the various conditions usually attributed to torpid-

TRH BTOXAGIT.

ity of tho livLT ai'o generally diie to pnisonirig of tlis.-
Bjetera by toxic eubstaiieea absorbed from llio alimen-
tary canal, wliich may bo e-ilber the result of tlie piitro-
faction of food in a dilated atoniacli or colon, or the
prodncta of uuperfect digestion.

Excessive eating also occasions injnry to the health
by producing an excessive fulneaa of the blood-vessels,
tbna incurring the risk of ruptnre within the brain, and
rpaulting paraiysia. Other equally aorioua mischiefs
may arise from the accnmnlation in the system of a
greater quantity of nutritive material than can bo ntil-
ized, which occasions general clogging and obstruction
of all the bodily functions, and imposes an enormous
burden upon tlie kidneys in tho elimination of the nn-
nsable nmterial.

Jljithiif tiK> Little. — -A far less common fault
than tlie one last mentioned, ia eating too little. The
instances tliat occur are usually In the cases of those who
have attempted to subject themselves to a rigid dietetic
regimen for the prevention or cure of disease, and who,
from having only a pailial view of ttio aubject, enter-
tain extreino notions. By the weakening of tho system
which neecBsarily occura when an insufficient amount of
nutriment is received, the etomach also becomes weak
and debilitated, its secretions and muscular efforts being
gi'eatjy impaired in both (juantity and quality.

How Much Should a Person Eat?— Thou-
sands of times lias tlie writer been asked, this question,
The only reply that can bo made to this inquiry is,
Just so nmch as tho systura needs and tiie digestive
organs can digest. In general, an individual may take
as much food as he can digfst ; but often there are con-

HALADISB OF THE BTOMAOB.

83 ■

ditions in which he cannot digest as mnch as he really
needs. For instance, when aa individual ia called
upon to exert all his energies of brain aiid muscle, to
straiu every nerve to its iitiuost, to compass a certain
-object of great importance, to cope with an emergency,
he may bo, for the time beiug, quite nnablo tfi digest
Buflicient food to make good the waste that must uec-
eeearily occur. Ho will lose flesh an<l strength under
Buch circuinstancee ; and often a failure of the ajipetita
at BUf^h a crisis indicates the inability of the stomach to
digest, on iicconnt of the defieiont secretion of gastric
juice. It is in this way that persons who are for a time
called npou to make great exertions often break down
their digestion. Thinking that they need abundance of
nutriment, which is true, they eat as heartily as when
required to i>ert'onn only their ordinary work, not con-
sidering their diminislied power to digest and appropri-
ate food, and in a short time find their digestive orgaus
unable to digest well even a small amount of food.
There is little doubt tliat this is what causes many law-
yers, phypicians, and other professii^nal men to break
down. If, when called npon to do a largo amount of
extra work, tlie person would lessen the quantity of
food eaten, instead of increasing it, he would conserve
his vital forces much more than by pursuing the oppo-
site course. When required by a press of business to
do extra work, often working for sevci-al days in suc-
cession with very little sleep, the writer has been in the
liabit for many years of limiting the amoimt of food
taken to not more tlian half the Dsnal allowance, and
sometimes to even a less quantity. The result has in-
variably been all that could be desired ; since, although

^+ TUB STOMACH.

several ponnds of flesli are often lost during an ordeal
of titis kind, wh«n it is passed, and the usual routine of
wnrk is resumed, tite digestive powers are intact,, and
abki to digest the anioant of iood necessary for retru-
jH.'1'tilioa, so that a few days suffice to restore the iiBual'
weight, and without loss of either strength or time.

It is evident that the diet of each individual mnet
be regutati'd in quantity according to his occu]>ation.
It must also be adapted to liis age. A man engaged
in severe physical labor, while he really requires
less food, may be able to dispose of more foi>d
than one who labors with equal intensity in some men-
tal pursuit. The body is wasted much more ra]>idly by
vigorous brain labor than by physical ejiercise only.
Indeed, it is asserted by our best authorities in physi-
ology, that three hours of severe bnUn labor arc equal
in exhausting effects upon Uio system to ten hours of
physical labor or muscular effort. It is evident, then,
that a man who works his brain constantly for ten oi-
twelve h'lurs a day really needs more f<x>d to sustain
his strength than a man who employs his muscles for
the same k-nj^h of tune.

But, as before remarked, the muscle laborer may be
able to dispf)se of more food than the brain laborer,
tliongh he needs less, since his vital forces are not so
completely exhausted by his work. In other words,
the occupation of the muscle worker being less exhaust-
ive than that of the brain worker, he can overeat with
greater impunity than can the latter. Each should
e»t only the quantity actually reqniri'd, if he wonld en-
joy the maximum of health and vigor ; but for the man
whose vital enetgios are daily exhausted bj mental ef-

ALADIES OF THE STOMACH.

S5 ■

fort, any excess in CRting ib certain to be most disastrons.
We have examples of great literary men who have been
large eaters ; but it is a noticeable fact that these per-
sons, in many instances, while celebrated for their pro-
ductions, often worked very leisurely, their fame being
really more largely attribiitable to brilliant genius than
to great application. In several cases, too, as iu that
of Charles Dickens, the hoiirg spent in brain labor were
chosen frani the best of tlie day, much time being
spent in physical exercise, by wliich means the integrity
of the digestive organs was maintained to a degree
that would otherwise have been impossible. In not a
few instances, too, tliose great literary men wlio wore
noted eaters died early, their physical stamina being
exhausted by the double drafts made upon it. Newton,
when engaged in the most severe portiun of his won-
derful lalH^irs in demonstrating tlie law of gravitation by
computations respecting the orbit of t!ie moon, confined
himself to a spare diet of bread and water. The great-
est amount of food is required by the person who is
actively engaged in both physical and mental labor.

The amount of food required by an individual, as
already inthnated, varies at different periods of life,
according to the degree of vital activity. In infancy
and childhood, when the vital activities are at their
highest degree of intensity, — when growth and develop-
meut are to be maintained in addition to supporting the
wastesof the system. — the demand for food Is greater in
proportion to tlie size of tlie individual than at any sub-
sequent time. In adult life, when waste and repair are
about equally balanced, a sufficient amount is needed
to make good the daily loss from the vai-ious mental.

physical, and other vita! activities wliicli can only be
eapporled at thu expense of tissue. Any larger quan-
tity than this is cxouss.

In old age, when the assinillativQ powers are weak-
ened by declining years, the amount of food which can
be assimilated by the individual is even somewhat less
than what is really needed ; hence, as age advances,
the quantity of food should be gradually diminished.
Very maTiy old people break down much sooner than
they would otherwise do, were they more careful in
this regard. When they lay aside their vigorous, ac-
tive life, they should also curtail the quantity of their
food. By tliia act of temperance, tliey might preserve
intact to a much later period the integrity of their di-
gestive organs, and so add years to their lives.

In not a few instances, the fotmdation of dyspepsia
is laid by some mechanical injury, as a sprained ankle,
a broken limb, or a severe bruise or cut, which requires
rest from active exercise for a few weeks. Not con-
sidering the fact that much less food is demanded when
a person is nut engaged in active labor of any kind than
at other times, the individual continues to eat heartily,
and soon finds his digestive organs rofnaing to do
their work from sheer e-thaustion. On this account, it
should be made a uniform cnstom to eat lightly on the
weekly reat-day. The hearty Sabbath dinners in which
many people indulge, making the day an occasion of
feasting rather than a rest-day, cannot bo too much
condemned. The custom is without doubt responsible
for many other forms of Sabbath -breaking, as no one
can have clear perceptions of right and a quick sense
of wrong when laburing under the ineubue of an over-

' THK STOHACII.

STi

loadtid stonuiL-ii. For the liearty meal usually token, it i
would be well to snbstitute a light one, consisting mostiy-fl
of fruits and grains.

This plan, if pursued, would do away with much o£S
the drowsiness iu chnrcli of whieli many people andj
not a few pastors have abundant reason to complain.
The intellect would bo clearer, and hence better able to I
appreciate the privileges and comforts of religion. The j
sooner people recognize the fact that stomachs havel
much to do with religion, and that true religion includes I
the government of the appetite, and frowns upon abuse-3
of the stomach aa well as abuse of a fellow-mai'i thfl'.J
better it will be for both Btomachs and religion.

Each individual must, to a considerable extent, bol
his own guide respecting the exact amount of food tol
be token at a given meal. If tho ap])etite lins been sol
long abused that it is no longer a safe guide, then roa-I
son must rule. The individual should, at the be-^
ginning of tho meal, determine just how much he will J
eat ; and when the specified quantity is taken, he must J
resolutely stop eating, leaving tho table, if necessary, to "I
escape temptation. The practice of serving fruit, pad-,
dings, nuts, confectionery, and tidbits of various kinds J
as a dessert, is a pernicious one. In the first place, it |
is an inducement to overeating, since it is quite proba-l
ble that enough has been eaten before the dessert is J
served. If the articles offered are whtjiesome, they J
should be served and eaten with the meal, as a part of I
it, and not at its close, in addition to the meal. Fnr-|
thermoro, it is generally the case that most of thearticlea J
served at dessert are wholly unfit to be eaten at any time, ,1
and BO should bo discarded. Dessert is really an in- 1

THE STOMACH,

genious device to leiui ]>en|)l(j to make dyspeptics of
tliemselvea by eating more tLuu tlioy nt'ed.

A man wlio 'desires to be at peat-e with his stom-
ach should learn to stop ■when lie has enough, no
matter how strongly he may be tempted to do other-
wise. There is mutli more truth than poetry in the old
Scandinavian proverb, " Oxen know when to go home
from grazing ;. but a fool never knows liis sttimach's
measure." But experience, a dear school, onght after
a time to teach the most unobservant person the amount
of food his stomach will bear without discomfort and
without injury. If a person in fair health finds tliat
after eating of wholesome food he is troubled with ful-
ness of the stomach, dulness over the eyes sonr
stomach, eructations, or flatulence, he may bo very sure
that he is eating too much, and ho should continue to
diminish the amount taken at each meal until the symp-
toms mentioned disappear.

It is well to bear in m.ind that the danger is prettj
much all on the side of overeating, the liability of
ing too little being very small indeed, Tlie tondeuoy
to overeat will be greatly lessened by eating very slowly,
masticating the food thoroughly, and eating only the
aimplest articles. One who has never made tlie experi-
ment will be astonished to see how little food is really
required to support life. The writer has lived for
months at a time on an average of seventeen ounces of
solid food per day, gaining flesh the whole time. Cor-
naro, an Italian nobleman, lived for many years on
twelve ounces of solid food per day (by solid food is
meant the weight ),

Numerous experiments by Letheby, Farkes, and

T TBS STOH&CB.

many ociier scientists, together with a careful study of
ttie dietaries of various classes of artisatiH, laborers,
professional men, etc., show that life can be well sup-
jiorted upon twenty ounces of carbonaceous and two
and one-lialf ounces of nitrogeuous food per day.
Pugilists in training usually take but twenty ounces of
solid food, and numerous classes of individuals subsist
upon a considerably less quantity.

By refereTico to the table of nutritive values given
on pages 41, 42, it will bo easily possible to ascertain
the amount of nutriment consumed in any given quan-
tity of different varieties of food. It is perhaps wortliy
of remark that the grains, as shown in the above table,
are by far-the most nutritiouB of all tlie various classes
of food. It will be observed, for instance, that oat-
meal, Indian meal, and peas contain three times as
much real nutriment as lean beef. 'When economy
must bo considered in the selection of food, this is a
very important consideration ; and it becoiuea doubly
evident when we consider tliat it takes eleven pounds
of vegetable food, including Indian meal, dry hay, etc.,
to make one of beef. It thns appears that a pound of
beefsteak, or second-hand grain, costs thirty times as
much as a pound of grain taken at first hand, besides
being vastly inferior in quality.

Deficiency in Necessary Food Elements.—
The food may bo abundant in quantity, and yet defi-
cient in one or more of the various elements which
go to make up true food. If the food is deficient in
farinaceous and fatty elements, tlje individual will
soon show signs of emaciation in consequence. A lack
of the nitrogenous elements will occasion still more

THE STOUACS.

markeil effects, eansing tho Btomai'-h to lose its tone
and vigor, tlju8 giving rise to acidity, flatulence, and
variouB associated distiirbanceB. The deficiency of the
coareer, innutritions elements of tlio food is also very
Boon felt by diminislied activity of the stomach and
Ixjwels, both in seeretion and in mnscnlar action.
Hence tlie great impOrtan<« of clioosing carefully and
judiciously the articles of food to be taken, especially
when a regular dietary is to be followed, 8uch a selec-
tion should be made as will supply to the system all
the elements of nutrition in proper quantity. To em-
ploy a dietary in wliidi any one of the nutritive ele-
ments is dtificient, although the quantity of the food
may be all that the digestive organs can digest, is as
really stiirvation, and will as certainly occasion the
same' results ultimately, as total deprivation of food.
To attempt to live on white bread and strong tea or
coffee, is as certain to impoverish the blood as to refrain
from eating alttigethcr, the only difference being in
the length of time required to bring about the result.
Thousands of pale-faced, anemic, thin-blooded, nerve-
less, dyspeptic women owe all their troubles to an im-
poverished diet. Tea drunkenness is not an uncommon
thing ; and in consequence of its pernicious influence,
the sagacious physician not infrequently finds as well-
marked cases of scurvy among ladies of the higher
classes of society as among the poorly fed sailors of
the whaling vessel after a long voyage, with prolonged
confinement to a monotonous saline diet. Young ladles
who attempt to exist with little other food than tea,
pastry, and confectionery, need not wonder that they
grow to bo lank, sallow, liollow-cyed dyspt^ptics. Tin-

' THE STOMACH.

der Bucli a regiiufii tlio mcist liardj quadnipetl would
saccnmb.

Many parents weaktm the digestive organs of their
little ones for life by fL-oding tliem whfii very yonng
up<in such InsafRcient diet as corn-starch or arrow-root
gruel, and Hiniilar preparations, and when they become '
olJtT, u]ion fine-llnnr bread. Kepeated experimentB have
shown tliat a dog will die of starvation in a month when
fed upon wliite or fine-ilonr broad alone. Fed upon
bread made of the wliole grain, or graham bread, dogs,
as well as other aniiuals, Buffer no deterioration in
weight Of in strength. Tiie difference between fine
flour and graham flour is largely in the proportion of '
gluten which they contain. Fine flour ia made from
the innermost portitm of the grain, which ie almost
pare starch, thus excluding the brain-, ticrve-, and mus-
cle-nonrishing elements which are fonnd chiefly in the
portions of tho kernel which lie next to the outer hnsk.
Whole-wheat flour also contains portions of innutritions
matter which, under most conditions, are advantageous,
enconraging both secretion and muscular attivity of the
bowels, and thus preventing constipation, which is often
a forerunner of more serious disease of the digestive
organs. There are cases in which the coarser portions-'
of the bran do liarm by cansing irritation ; but these
do not often occur.

It should be added that the more recently perfected
processes employed in the manufacture of patent flonr,
afford a product which is botli fine and nutritions, both
the innermost portion of the ternel and the bran being
discarded. But in connection with this, there is also b
gra^Jo of flonr made, kiiown aa '-family flour,"' which

THB STOMACH.

coiieistB only of tlie centra! portion of tlie grain. Tlie re-
inai'ka re8|3ucting fine flour apply especially to this prod-
act, and not to the best brands of patent flour. The
ao-called "pliitcn flours" whicli are extenBively adver-
tised, are for the most part inferior to first-class wholf-
wheat flour, and are ncvtT in any way superior to it.
Mufli (hat is B'lld nnder the name of grahum flour
eiiiisists of inferior fiiniily flour mixed wilh coarse
bran. Such grahmn flour is not to be recouimended.
The best gi-ahaui flnnr is that made by the old milling
process, in which etones, instead of steel rollers, were
used for grinding.

While it IB necessary to havu all the elements of
the food in proper proportion, it is of first importance
lliat tho nitrogenous elements be suflicieut in quantity,
even if it slujuld be necessary to make use of an ex-
cess of farinaceous foods to sfc-uro the proper amount,
since it ia of these elemonta tliat tlie vital portions of
the body are fonned. Tlie following table shows the
respective amounts of different articles of food rctiuired
to fnrninh flie requisite quantity of nitrogenous matter
for one day : —

Iiean Meiit 15.8

Eggs..,. 21.2

Peas 11.3

Oatroeat 23.8

Baker's Bread 3(1.7

Wheal Flour (flat-) 27.5

OrBliam Fluur Sri. 5

[Ddlan Meal aa.8

RyeMeul ^7,1

rnunda.

Rice 3.0

Potatoes 8.8

Carrots 1 1.3

Turnips !o.4

Cabbage 15.4

Parsnips 16.9

Ptnta.

Boer 1S5

Milk 4,5

By reference to the above table, any one will be able
80 to combine various articles of food as to secure the

lUt^DlKS OF THB BTOUAOH.

propur ainiiiuit of nitrogenous matter witliout overload-
ing the digestive organs, and yet give to tlie food the
bulk necessary for good digestion. Evidently, it would
overtax the stomach to digest turnips in sufficient quan-
tities to supply the wants of the body, while lean meat
would afford an insufficient amount of bulk, as well
as a deficiency of carbonaceous matter. By a combi-
nation of such nitrogenous seeds as lentils, peas, and
beans, or of oatmeal or wheat mea), witli potatoes or
(ilher vegetables, the difficulty may bo overcome, as
also by combining eggs wilh the carbonaceous grains .
and vegetables.

The projKn-tion of carbonaceous and nitrogenous
fi>od elements retjuired for the niaintenunc^e of health U
about one part of the latter to seven or eight of the
former. The following table, including a few of the
more important articles of food, will give a clear idea
of the relative projxirtiou of the two elements in the
articles mentioned : — -

Lean Beet

1 .5
1 l-fl
1 3.7

1 a.«

I 5.0

1 G.i

I 7.7

Wheal Menl or

Pens

Rye Mta]

Ofttmoiil

IndiaDMeal

Barli'V Menl

Ilice

According to M. Germain S^e, of Paris, one of

the most eminent French phyaiciana, observations upon
different races and physiological experiments show that
the amount of albumen heretofore supposed necessary
for tljo maintenance of health is greater than is actually
required, and that tlie proportion of this element need
not exceed one ninth to one tenth. About the sa

TBK STOMACH.

smount of fst is required, the balance to be sUirch
or 8agar. According to this authority, twenty to
tweuty-oiie ounces of water-free food is required for a
daily ration, of which two to two and one- third
ounces should bo albumen or its equivalent, two ounces
of fat, and the rcmaiudor starch and sugar. As we
have elsewhere shown, starch is much to be preferred
to sugar as a form of carbonaceous food. This re-
mark, of course, applies especially to cane-sugar,
since the sugar of fruits is already advanced in the
digestive procoas, whercuB cane-sugar Luiders diges-
tion, and produces gastric catarrh.

The Quality of Food.— Man, like other animals,
is made of what lie eats, and we may well credit the
assertion of an enilnunt autlior, that the general ten-
dency of tliought in any nation may bo determined by
the character of the national diet. True as this princi-
ple is when applied to the body in general, it is espe-
cially true In referenc'e to the stumach. No oi^an is
so directly and so in-ofirandly affected by the quality of
the food as is the stomach. Hence we may well con-
sider with care the various ways in which the digestive
organs may become impaired through defects in the
quality of the food.

Bad Cookery. — As a ptitent cause of dyspepsia,
bad cookery deserves lirst mention in tliia connection.
The real object of cooking is to render the elements of
food more digestible. It is intended, indeed, to be a
sort of partial preliminary digestion of the food; but
the numerous devices of cooks and caterers, with tlieir
complex and indigestible mixtures, have so far sub-
verted the original design of the pi-ocess as to render

MALADIES OF THE 8TOUACQ.

cooking a moans of making food indigestible as often
aa otherwise. Altngetlifi- tmj littlo attention is paid to
"the Hubject of cookery as a scienee. In the majority
of cases the task of prepiiring food for the palate (the
stomach is seldom thouglit of) is intrusted to ignorant
servant -girls or colored cooks, who compound their mix-
tures by "the rnlo of thumb," and without any ref-
erence whatever to the physiological wants of the body.
Some alight indications of reform in thia direction are
shown in the eslablishment of edioola of cookery in
the larger cities, and lectureships on the Bubjeet in some
of our female seminaries. To become a good cook re-
quires as much native ability and far more practical
ex]>erionco than to become a musician or a school-
teacher, or even to entiT some of the learned profes-
sions. The position of cook ought to be made so re-
s|)ectable and lucrative that it will attract persons of
sufficient mental capacity and culture to make the art
subservient to the purposes for which it waa first em-
ployed and designed. A bad cook in a family is a
worse enemy to tlie health, tlie eiimfort, and even the
murals of the household, than would be a swamp gen-
erating malaria a half-mile away, a cesspool fever-uast
at the back door, smallpox across the street, or a Chi-
nese josa-house in the next block. Give tis good
cooks, — intelligent cooks, cooks who are thoronghly
edncated, — and the cure of nine tenths of all the
dyspeptics may be guaranteed, without money and with-
out medical advice.

Fried Food. — Of all dietetic abominations for
which bad cookery is i-esiKmsible, fried dishes are the
most pernicious. Meats, fried, fricaaseed, or other-

wise cooked in fat, fried bread, fried vegetables, dongh-
ntits, griddle -cakes, and all other similar oonibi nations
of melted fat with other clemente of food, are must
difficult articles of digestion. None but the most
stalwart stomach can master such indigestiblcs. The
gastric jaice has litile more action apon fats than has
water. Hence a pfirtion of meat or other food satur-
ated with fat is as com]itetc'ly protected from llie action
of the gastric juice as is a ftxit within a well-niled boot
from the snuw and water outside. It is marvelous in-
deed titat any stuinach, under any circumstances, can
digest such food, and it is far fn>m remarkable that
many stomaelis after a time rebel.

It is principally for this same reason tliat rich
cake, shorlened pie-crust, and pastry in general, as
well ae warm bread and butter, so uotoriuusly disagree
witli weak stomachs, and are the efficient cause in pro-
dncing disease of the digestive organs. The digestion
of tlie fuud being interfered with by its covering of fat,
fermentation takes place. The changes occasioned in
the fat develop in the sttimach extremely irritating and
injurious acids, which irritate the mucous membrane of
the stomach, causing congestion, and sometimes chronic
inflammation.

VDCooked Food.^ — Raw foi>ds and food which
has been insufficiently cooked, are a frequent cause of
indigestion. This is especially true of uncooked vege-
tables. Man is naturally a frugivorous animal, and is
able to make use of vegetables and many grains as food
only by the aid of cookery.

As will be recalled, the digestion of starch is effected
by both the saliva and th« pancreatic juice. Salivary

HALAonca or tbb stomach.

d'gestioii takes place in tlie raotith imd the stomach, —
chiufl^ in the stoiiuich, of cmirsf, as tlio food is not
retained in the mouth for a 6u9icit.'iit length of time to
allow the dig«stive process to proceed beyond the pre-
liminary stage. In the digestion of starch, the starch
ie &'Bt rendered Boliihle, and is then converted into
dextrin, and finally into malt-sngar, or maltose. The
digestive principle of the saliva is iucipabie of acting
upon raw starch, but the pancreatic juice digests raw
starch, although with k-aa facility than cooked starch.

By the action of heat the starch granules, which
consist of the starch proper enclosed in little capsules,
are ruptured, and thus the digestive juices can readily
come in contat^t with and digest the starch.

By the prolonged action of moderate heat, or by
exposure to a high temperature for a sliorter time,
starch is converted into dextrin, Similar changes
take place in ripening fruit. Green fruit contains a
large amount of starch ; in the process of ripening, this
starch is converted into dextrin and sugar, aa in the
process of digestion, so that in the ose of fruit the starch
is taken in a partially or completely digested state,
which accounts for the easy digestibility of this kind
of food.

When starchy substances are eaten raw, tlie saliva
being anable to act npon the uncooked starch, the
gastric juice cannot gain access to the albnmlnous sub-
stances present, and hence these particles are not
brt>ken np, and being retauied in the stoinach for too
long a time, fennentation and irritation are the resnlt.
It is for this reason that green fruit and raw vegetables
occasion so much disturbance of the stomach and

THB fflDV ACH.

bowel*, tBe«e iuunatnre foods contaiaing lar^ qttanti-
lun of March in a rery indigestible state. Bv cooking,
unripe fmit and regetablcs maj be in a gi^at d^r^e
deprived of tbeir iojonotu properties. Cooking 19 tfaos
a aort of preliminarr digestion.

In Scoiland, the enring of osnucal imperfectly
cooked is a vrry ct.mmfin pracliw. iU« result of which
ia olmofit niiiversal Biifferiog frum a peculiar tuna
at indigeetion dae to it, known as water-brash. The
Scotch fanner prefers his oatmeal taw becaase of its
indigeRtibiliry, as the resnlt of which it "Btavs by the
stomach" longer than when well cooked. Nearly all
kinds of food are uinch more easy of digestion after
cooking than before, providing the crK)king is per-
formed in the proper nianner. For vegetables and
grainn, cooking is especially necessary.

Decayed Food. — Much harm eoraes from eating
food which has made appreciable advancement in the
direction of decay. Tliis ia true both of vegetable and
animal food. By the process of decomposition, poison-
ouB elements are developed in animal and vegetable
HnbHtanceH, especially the former, which do not nat-
urally exist there. If decomposition is far advanced,
tlieeo poisons may exist iu snch quantity as to produce
imraodiato ill effects, sometimes occasioning death in a
few hours. iTialancos of this kind have often occurred
from catiDg canned meats which had spoiled, or which
had boon kept for a slifjrt time after opening. The
practice in vogue in some other countries, and to a cer-
tain extent in this of keeping meat for some days
before eating, so as to give it tenderness and a "high
llnvor, is a most pernicious one. Better far, for health.

UALADIXS or TBB BTOMACH.

I the barbarous Abyssinian custom of eating the flesh
raw and whilo still warm and quivering.

For dyspeptics such food is especially bad, siuco
digestion is so slow that decomposition is not corrected,
as it is to some extent in a healthy stomach, by the
gastric juice, bnt is allowed to continue, with all its
serious consequences E\cn if no immediate effects
follow the UBO of such food, the poisons generated
may be absorbed, and appear later in some form of
blood-poisoning. The stomach of a hyena may be able
to digest the putrid flesh of a decaying carcass ; but
raan^s stomach was not intended for scavenger use, and
requires fiesh, untainted food.

Sholl-fish, and, in fact, fish of all kinds, are par-
ticularly prone to decompositinn, undergoing this change
much more quickly than do other forma of animal
food. It ifl partly for tliis reason that poisoning from
the nse of oysters and fish occurs so frequently, and
sometimes with fatal results. Experiments recently con-
ducted by Trombetta, an eminent French physiolo-
gist, show that decomposition of flesh begins within
twenty-four to forty-eight bours after the death of the
animal, even when the flesh is kept within a refrigera-
tor. Germs rapidly increase after tlie death of the ani-
mal, and even after so short a period are found in
abundance. It thus appears that all flesh food must con-
tain more or less of poisonous matters, the products of
decomposition. Bouchard has shown that meat juice
is very deadly in its effects when injected into the veins
of an animal, in consequence of the poisons which it
contains. Beef tea is, for the most part, made up of
soluble substances contained iu tlio flesh of the animal at

100

THE E^TDMACH.

deatlt, or derelcyped h\ tbe actKMi of germs after death.
An eminent French phTfttdan, epealdng c^ beef tea,
letnarked that "it u a tme eolation of ptomains ''''

(poieone).

Cheese is anoiher article which onntains poisonnus
Bnbatanccs known us yiiomain^ in great quantities, and
not only poiwms, bnt g»njis capable of producing poi-
Bons in abnndauce id tbe etomacb. Cases of cheese
poisoning are a frequent and eonietimes fatal result of
the nsc of cheese. Cbnleni nh^rhns, a disease due to
germs, is frwjiientlv induced by eating cheese. Tliat
poisoning does nt>t alwajs occur from the use of cheese
is due to the fact tliat the gastric jnice of a healthy
stomach is capable of destroying a considerable quantity
of germs, and that the liver is capable of destroying
the poisons intnxlnced with the cIkkjsb in considerable
amount. Milk sometimes gives rise to indigestion and
serious illness in consequence of the disease-producing
microbes which it contains.

Soft Food.— The structnre of man's teeth indi-
cates that he was intended to employ a diet consisting
of food of such consistency as to require vigorous
mastication. His jaws are armed with thirty-two
strong teeth, compactly arranged in the mouth in such
a manner as to make thorn moat available for use.
Obeying the general law governing all organized struc-
tures, by which organs develop or degenerate according
as they are used or allowed to remain inactive, the
teeth retain their health if vigorously employed in the
mastication of solid food, but raj^idly undergo decay
when not thus nsed. We have an illustration of this
in cows fed on distillery slops. The teeth of such

MALADIES <iF TRK STOMACH.

101

9 decay and drop out for want of use, wliilu tliosa
of tattle wliith keep their teeth actively employed iu
chewing tbe cud are preserv ed intact

The effect of Boft food npon the teeth of an animal
ia well bIjowii in the accompanvmg ilInHti'ationis.

Fig, 14 reprcHunta the teeth of a cow fed upon proper
food. Fig. 15 showa the teeth of a cow fed upon dis-
tillery alopa.

The same is true of human heings. Eating aonps,
gruela, and other soft foods, to the exclusion of articlus
requiring mastication, ruins the teeth at the same time
that it diaorders the stomach through the taking of too
much fluid, tiius causing deficient iuaalivation.

Too Abundant Use of Fats. — Unfortunately
for the poor stomach, the opinion prevails almost
everywhere that food niade rich with fat ia the most
nourishing. Undoubtedly fat is an element of nutri-
tion, and can be digested and aaaimilatcd when taken
in proper quantities and in a proper manner ; but the
cessive nee of fata of varioua kinda, aa lard, auot,
butter, and other animal and vegetable fats or oils, ia a

103

THE STOMACH.

]>iYjlifif cause of certain forms of iiKligcstion, especially
that kuuwii as bilious dyspepsia. The famous [ihysiol-
ogist Bernard many years ago dettrmiued by can-ful
experiment tlie fact that the free nse of fats greatly
reduces the biliary secretion, the quantity of bile be-
ing diminished in some instances to a very sraall fraction
of the amonut secreted when only pure water or food
containing little fat was taken. When it is remembered
that the bile Is an essential element for the digestion of
fat, it will bo seen that a dimination of this digestive
ilnid in connection with the taking of an extra quantity
of oleaginous matter is a most unfortunate circum-
stance, since it is thus absent when most needed. This
fact sufficiently well accounts for the distressing symp-
toms which acojnipany the excessive use of fats by
those whose digestion has been already weakened by

abuse of this kind. The diminished quantity of bUe
produced by the liver is also sufficient cause for the
condition established by the over-uso of fats, vulgarly
known by the expressive term "bilious." The ele-
ments which ought to bo eliminated from the system

MALIDIES OF THE BTOMACH.

103

are retaiuud, clogging tho vital macliinory, and giving
rise to many HymptomB of systemic poiBoning.

When it is remembered that the bile is the antisep-
tic ogeut by which the contents of the aniall intestines
are preserved from decom|JOyition, it will readily be
seen that a deficiency of bile must result in decompo-
sition of food elements, and the formation of poisonous
snbstancGs. The absorption of these substances still
farther' disturbs the liver, contaminates the body, and
produces the condition of general poisoning which
is commonly termed biliousness or bilious dyspepsia, a
state which is not to bo remedied by the use of liver
medicines, purgatives, etc., but by correction of the
diet.

Fats readily oudergo docom|X)8ition in the stomach,
especially in a stomach which is dilatfd so that the food
is too long retained, or in one which is the seat of gas-
tric catarrh. It is on this account that fats, even in
the form of butter or mingled with the food, as in
rich gravies or the shortening io pic-cruHt, are so often
a source of irritation and distnrbanee in dyspeptic
stomachs.

The nse of rich foods is not infrequently a cause
of bilious headache or a bilious attack. Aiiimal fats
are more likely tti undergo this decomposition than are
vegetable fats. Ordinary butter is particularly un-
wholesome, for tiie reason that it always contains mul-
titudes of microbes derived from the milk, which are
rapidly developed in the stomach, producing decom-
position of the fat, and tlius forming irritating fatty
acids. Only sterilized butter is tit for human con-
sumption.

Cooked fata are also mucli more irritating and likalj
to produce indigestion than uncooked fats. Tlie process
of cooking develops acrid faltj acids which are ex-
tremely irritating to the gastric mucous membrane.
This is one of iJie reasons whj fried and fricasseed fooda,
griddle -cakes, doughnuts, Saratoga chips, etc.. are so
harmful to digestion. Fata taken in the form of creain
are generally mora digestible than in any other way.
In some cases, however, there is an inability to digest
the casein of milk in the form of cream ; for such eases
sterilized butter is to be preferred. Tlie least harmful
mode of using a free fat is in the form of sterilized but-
ter taken with cold bread. Melted fat taken with fari-
naceons substances ia extremely hurtful, as the starchy
particles are so completely surrounded and permeated
by the fat that the saliva, which should act upon the
sturcli iu thti^ stomach, is unable to do so, thus leading
to indigestion.

The use of natural foods containing a sufficient
quantity of fat is much to bo preferred to the use of
free fat. In cream the fat ia iu a finely divided state
in which it can mingle readily with the fluids of the
stomach ; hence it docs not smear over those food sub-
fltancea which are acted upon by the gastric juice and
the saliva, thus preventing their digestion. Neither
the gastric Juice nor the saliva has any action upon fat,
and for this reason free fats may constitute a very
serious obstacle to the action of both the saliva and the

gastnc juice.

Nuts also afford a most excellent form of fat.

The

popular idea that nuta are difiicult of digestion is the
natural outgrowth of the common habit of swallowmg

MALADIES OF THE STOMACH.

105

them ■without masticarioii. Nuts have a firm, hard
structure, requiring very thorough mastication. If
pains is taken to chew tlicm very thorouglily, nnts are
as digestible and wholesome as any other food, and
they are highly imtrilious. Lack of sound teeth is, in
some cases, an almost insuperable obstacle to the
proper mastication of nuts, as well as of other hard foods.
The writer has succeeded in meeting this difficulty — in
the case of nuts, at least^by preparing from some of
the best and most nutritious nuts a very fine and thor-
oughly cooked meal, and also a nut cream or butter. -
The latter, like eream, is nearly a perfect euiuljion, but
is, at the same time, so rich in fat as to be an excellent
substitute for butter. It is especially useful in season-
ing foods, and serves a most excellent purpose as a
dressing for vegetables and other foods which are
deficient in fats. These nut preparations are manufact-
ured and sold by the Sanitos Food Co., Battle Creek,
Mich. ( See page '2-i\.)

The Use of Sugar in Excess. — While sugar,
like fat, is a true alimentary principle, capable of aid-
ing in the maintenance of life when employed with
tlie other elements of food, if used in excess, it becomes
a serious source of disease. When used alone, it is
utterly incapable of supporting the vital activities of
the body, being, in this respect, analogous to starch,
its food equivalent. The popular idea that sugar nour-
ishes the nerves or the brain, makes the teeth sound,
and is both harmless and wholesome, is quite a mistake,
as many an innocent little one whose fond parents
shared in the general error, has found oat to the regret
and sorrow of his friends.

Tfae diSeraai fonns <t c^ar, swlaaseB, sir^i, trea-
de, hoMn, cSc. an mamrially tfae mmr in their effects,
cxocfri dm mc^Meei and bonejr sc^MtiiBeB contain pecul-
iar demema tfaat to aome pefsoas seem to be almost
active potsoos. Tbia is eqiMiall j Ime ot faonej.

Tlie injuiT fmm die use of ea^a or odi^ saodurine
fiabstances is occSBioDed, firet. bj die readiness tnth
wfaidi it Dndergoea fermentadon vWn f:Qbiooted to
warmtii and moisMire. In the stomach it finds all the
conditions neceseajy for inducing f^rmf^ntatiiiD ; and
were it not that eacdiarine sabstances is solation are
csnall; so qnicklj absorbed that it is diffiralt for the
chemiet even to det<Kt their presence in the stomach,
this chan^ would alwajs cKvar. When a larger qoan-
tit,v is taken than can bo absorbed prumplly, or when
taken in Bueh form as to make ready absorption impos-
sible, as in the case of preserves and sweetmeats of
varioQB sorts, acid fermentation docs occur, and with
scrions results not only to the stomach, but to the whole
system. Tlie fermentation set np not only develops
acids and gases from the sugar, but, being communi-
cated to the other elements of the food, as the starch
and oBpocially the fatty elements, still worse forms of
fermentation or decomposition occm"; and the fotxl is
tliiiM rendoi-ed unfit to nourish the body, while the mu-
cous ineuibraue of the stomach and intestines is irritated
by the contact of unnatural corroding elements in the
food, and thi-ough their absorption, the whole system
beconiCB uffccted.

Tlio cxccHHive usci of sugar also greatly overtaxes
the liver, wliit-li has an inijiortant part to act in its
digt^stion, intorforing with the proper performance of

MALADIES OF TBE BTOUACH.

107

ita other functions, eupecially tliose of bile-making and
poisoD-destroyiDg, and thus leaving tlio elemonta which
it ought to ellmiQatf), to acciimulato in the syatein.
Thus a person may become "biliouB" from the over-
use of sugar as well as fiimi the excessive use of fats.

When taken into the stomach in considerable quan-
tities, sugar givos rise to a profuse flow of mucus, and
may thus eventually develop chronic catarrli of the
stomach, which, extending into the duodenum and
the bile duets, produces catarrhal jaundice and the
partial closure of the biliary passages. When sugar in
used to excess for a considerable length of time, the
liver finally loses its ability to retain the sugar in its
tissues in the form of glycogen, — one of its most impor-
tant functions, — -so that an excessive quantity of sugar
is thrown into the blc»jil, and, being eliniiiiattd by the
kidneys, appears in the urine. This is the most fre-
quent and most common origin of diabetiv^ The writer
has met cases in which nearly a pound nt sugar was
thus eliminated through the kidneys in twenty-four
hours, and quite a number of cases in which more than
half a pound of sugar was thus thrown out of the body
in the same length of tiinu. Sugar is never found in
the oriue in a state of health.

Excessive use of sugar is also a most common cause
of obesity. The excess of carbonaceous nmierial in the
form of sugar being deposited as fat, or adipose tissue,
overwhelms the heart so that this excess of fat is some-
times attended by fatal resuhw.

Excessive Use of Flesh Food.— The flesh of
animals, especially lean meat, is namilly considered the
most easily digested and strengthening of all foods.

108

THE STOMACH.

Tliis fact, together with tho Btimulaling character of
lliiH class of foods, is, perhaps, the cause of its extensive
tiBt- in English-speaking countries, especially in Eng-
liind anil America. Tlio fact that itnmediate distress
and unpleasant symptuiua relating to the stomach itself
lcH» frefjuently follow the use of flesh food than the use
of many olliiT foods, is perhaps one cause for this mis-
apprchenaion. While it is trne that meat, especially
l«an meat, is muro readily digested iu the stomach
than coarHo vegetables, and is less likely to ferment^
foriiiiiig giiB and irritating acids in the stomach, than
are siicchai-ine and starch foods, it is nevertheless true
that inout>t ure, of all foods, most exciting and stimu-
lating to the stomach ; aud when freely used, the
ultimate result is to prodnce a condition of debility in
rhe Htomach, and in some cases gastric catarrh and
other wtomacli disorders may be attributed to the exces-
Mive use of nii^at. The worst effects, however, from an
excessive usu of meat aro to bo sought in the liver and
In the body in general, resulting in rheumatism, gout,
noiiraMtlienia, and a great variety of diseases which have
tlioir origin in the introduction of an excessive quantity
of t^ixic flubfttaiices into the body through the use of
meat.

Till? practice now much iu vogue, of administering
largi^ cjuantiticB of raw or under-done meat, either in the
form of an ordinary steak or chop, or spoeially prepared,
tm by Hcraping or mincing, has been productive of a vast
doal of injury. The writer has noted several instances
of acHte Bright's disease in which general Hyniploiiis
of poisoning and various nervous maladies could be di-
rectly attrihiit«d to following, for a number of months,

MALADIES OF THE STOMACH.

nil)

a prescription roqniriug raw meat as a principal article
of ilift.

Condiments. — ^B_y condiments are meant all sub-
stances a<l*le(! to food for the more purjwse of render-
ing it more palatable, but poBseesing no positive nutri-
tive value in themselves. Mustard, vinegar, pepper,
cinnamon, and various otb^r spices are included in
tbia category, together witL salt, although the last-
named article is by some h«ld to bo of the nature of a
food, and sapposed to snpply Bimio want in the body.

Mustard, pepper, pepper-eauco, cinnamon, cloves,
cardamoms, and similar substances are of an irritating,
Btimulatiiig character, and work a two-fold injury upon
the Btoniach, By contact, they irritato the mucous
membrane, causing congcsticm and diniiniBhed secretion
of gastric juice, when taken in any but very small quan-
tities. This fact was demonstrated by the observations
of Dr. Beaumont upon St. Martin. After several years'
careful study of the relations of various foods, drinks,
etc., to tho stomach, Dr. Keaumont stated, in summing
lip his experiments, that "stimulating condiments are
injurious to the healthy stomach," He often saw con-
gestion prtKluced in the nuicous membrane of St. Mar-
tin's stomach by his eating food containing mustard,
pepper, and similar condiments.

When taken in quantities so small as to occasion no
considerable irritation of the mucous membrane, condi-
ments may still work injury by their stimulating effects,
when long continued. The stomach being at first ex-
cited to more than natural activity, afterwartl suffers
from reaction, and is left in an inert, diseased state,
incapable of secreting suificient gastric juice to supply

110

the needs of the Bystein in dlgeeting food. Thia final
result is often averted for some time by increasing the
quantity of the artificial stimulas ; but nature gives
way at last, and chronic disease is the rosnlt.

In experiments conducted in the Laboratory of
Hygiene connected with the Battle Creek (Michigan,
U. S. A.) Siinitariiim, we have found that the use of
condiments does not increase the flow of oitlier saliva
or gastric juice, but causes an outpmiring of a great
quantity of protective mucus. When this becomes ha-
bitual, the individual is the subject of gastric catarrh,
a disorder which is by no means easily cured. The
writer quite agrees wilh the conclusious of the small
boy who, having tasted bnreeradish for the first time,
spat it out, remarking to his mother, " Mamma, I think
I won't eat that till it gets cold," Substances which
are hot when they are cold are not fit to be eaten. The
irritating and astringent properties of certain vegetable
substances were doubtless put into them as warnings
against their use by human beings.

In Mexico, where pe]iper, mustard, and other con-
diments are probably us'.'d more freely than in any
other part of the world, gastric catarrh is an almost
universal disease.

In the case of salt, there are several objections to
be urged, which are at least cogent against its excBssive
use ; and by excessive use is meant a quantity which
causes thirst either at or after meals, occasioned by the
feverish state of the stomach induced by the caustic
properties of the saline element. According to De-
bove, physiological experiments have shown that salt,
when taken in considerable quantities, int?rferes willi
the digestion of albumen. Tliia statement agrees with

MALADIES UF THE STOMACH.

Ill

tlio writer's own laboratory experimenta, as well as with
the experience of aailore, who, wlien making free use
of Bait meat, suffer from scurvy and a long list of symp-
toms indicating malnutrition and tissue starvation. Ex-
perimental evidence shows tliat liuman beings, as well
as animals of all classes, live and thrive as well without
salt as with it, other conditions being equally favorable.
Tins statement ie made with a full knowledge of conn-
tf-'r argniiients and experiments, but not without abun-
dant testimony to support the position taken.

The author does not, except in rare instances, advise
the I'ntire discontinuance of the use of salt; neverthe-
less, he believes that it may be greatly reduced in
quantity by all who use it, without detriment, and
with real benefit. Lerieho and others have shown that
salt, oven in so small a proportion as one per cent.,
diminishes both the amount and the efficiency of the
hydrochloric acid of the gastric juice, and thus gives
rise to fermentation, one of the most common symp-
toms of indigestion, and a csnse of many other morbid
conditions.

Salted food is very hanl of digestion ; and when it
is taken for a long time, the stomach often fails. A
piece of fresh fish which will digest well in one hour
and a half, requires four horn's after salting, according
to Dr. Beaumont.

Pickles.^ — Cucumbers, peaches, green tomatoes,
and numerous other fruits and vegetables are sometimes
preserved by saturation with strong vinegar. Some-
times whisky or some other alcoholic liquor is added to
increase the preservative property of the vinegar; but the
same process which mak"^ it imposnililc for the fruit or
vegetable to ferment or decay, makes its digestion

112

THE STOMACH.

eqnally difficult, if taken as food. Pickles are exceed-
ingly nnwluilesome aa an article of diet, and are often
the cause of acute dyspepsia. Those addicted to the
free use of pickles may be assured that tbey must cer-
tainly part with their favorite dainty or bid farewell to
good digestion. Cucumbers preserved with salt or vin-
egar are next to impossible of digestion. The pro-
verbial uuhealthfulnesB of this vegetable is a popular
notion based on exjicricnee with the article prcpai-ed
with vinegar and salt. These chemical agents harden
the delicate structiircB of the vegetable, and render it
almost unapproachable by the digestive juices. The
pure vegetable, unsophisticated by condiments, is no
more harmful than other green vegetables.

Vinegar.— As the use of vinegar is continually in-
creasing, attention should bo called to the fact that it
may be a cause of disease. Ordinary vinegar con-
tains about five per cent, of acetic acid, its principal in-
gredient. Like alcoliolic liquors, vinegar is a product
of fermentation, being the result of carrying a little
farther the same process by which alcohol is produced.
Vinegar is much more irritating to the digestive organs
than an alcoliolic liquor of the same strength. Its
exciting nature makes it extremely debilitating to
the stomach. Dr. William Roberts, of England, has
shown that bo small a proportion of vinegar as one
per cent., completely arrests the action of the saliva
npon starch. The writer's own experiments have con-
firmed the observations of .Dr, Huberts.

The moderate use of a light wine or of ale or beer
is mnch less destructive to the digestive organs than a
free use of vinegar. This remaik is made, not to com-

MALADns or niK stomach.

113

mend vine or beer, howerer, etnce tbe*e eabetsocta are
pi>Bses84xl of no virtue, and are capable of doling a tmc
deal of harm. Tbere is reallj no need of remaining to ao
inferior s eoorce for a mild acid, as we have tite want
met most perfectly in lemons, limes, citmns, mod otber
acid fniits. As a dresiting f(»r some kinds of TCfcetaUc
ffK)ds, lemon jnice is a perfect subetitnte for rinegar.
Recent obeer^-ations hare ^hi^wn that the wiattf^ ccb
which are nearly always to be fonnd in "f-ood dder
vinegar,*' often take up their alfode id the slimemary
canal, becoming intestinal par^
sites, and pro^lnmig macli Dii»-
chief, (Fig. 16.)

Vinegar is oft«n adnlterated,
containing a very small projwir-
tion, if any at all, of real afrple-
juice, its acidity being dae to
hydrochloric or sulphuric vri'l ;
therefore each vinegar ia even
more destructive to the faneti'ins of th« irtotnarh and
also to the teeih titan ordinary ritK^ar,

Tea and Coffee. — ClaMing theme fsv^/rita her-
erages with caosee of dyspep«is will efirtainly call forth
B loud protest from the namerona d*?vot<»-» of *• the fra-
grant cup," as among the nnrntMrr of those who argue
for their n>c are Dumerom leamol profeiwoni, an w<-t!
aa nearly the whole sisterli')'^ <^ the maidens, wivw,
mothers, and grandmoihem (*f the nation, along witli
a good pro{>ortion 'it thu br</tben>, bEultands, fathers,
and grandfathers atwo. Keverthelesa, It can be easily
shown tliat whatever action may bu aMignod to these

erages. It is unfiivurablo to digestion, rather than

pml k— Tf >bm« Ecul.

114

THH BTOMAOH.

Otherwise. Leaving out of consideration the objections
wliich may be nrged against the use of tea and cotfee
on other grounds, the following may be offered aa rea-
sons why they are object inn able on account of exerting
an injurious influence upou the digestive organs : —

1. Both tea and coffee contain an element resem-
bling tannin, which precipitates or neutralizes the pep-
sin of the gastric Juice, nnd so weakens its digestive
power.

2. Thein and caffein, the active principles of tea
and coffee, are toxic elements which diminish the ac'tiv-
ity of the glands of the stomach by which the gastric
juice is fonned, tJius intcrfei'ing with the digestion of
albumen and other proteid substances.

3. Both tea and coffoe are objectionable on the
same ground as other beverages in connection with
meals, on account of their disturbing the digestion by
dilution and consequent weakening of the gastric juice,
and by overtaxing the absorbents, tlius delaying the di-
gestion of the food, and giving rise to fermentation.

4. Experiments made by Dr. William Roberts, and
repeated by the writer, show that tea, even in a com-
paratively small amount, destroys the starch -digesting
properties of the saliva, — another fact which accounts foi-
the universal existence of indigestion in tea and cotfee
drinkers.

Alcohol. — Wc have not space in this connection
to dwell at lengtli upon the damaging effects of alcohol
upon the human system, nor the full details of its effects
upon tlie stomach. Tho following facts, however,
pre well worfh tho consideration of those who believe

MALAOnn OF THB STOMACH.

115 1

in the nse of alcohol either moderately or with greater
freedom ; —

1. Alcohol itself ia an active poison, which when
received into the stomach in a concentrated state,
almost as ^quickly fatal to life as is prnssic acid <
strychnia. It precipitates the pepsin of the gastric
jnice, rendering it inert.

'2. It irritates the gastric mucons membrane when j
taken in any but extremely small quantities, even beer
and the weaker liquors having this effect when long '
continued.

■i. The ultimate effect of alcohol is to cause degen-
eration of the Bccrettug glands of the stomach, by which
its utility as a digesting organ is destroyed.

Sir William Roberts, the eminent English physician
whose authority wo have already quoted, has shown
that alcohol diminishes the activity of gastric digestion,
III experiments made by the writer in the Laboratory
of Hygiene (Battle Creek, Mich., U, S. A.) it has been
found that half a pint of light wine lessens the digest-
ive activity more than one half ; aud that an ounce of
alcohol, well diluted, almost completely arrests stom-
ach digestion.

Dr. Beaumont's observations on the affects of alco-
hol are very positive and distinct in their indications.
St. Martin being an intemperate man, occasionally in-
dulging freely in drink. Dr. Beaumont had an oppor-
tunity of observing the effects of its use, as by the aid
of a strong light he could look directly into his patient's
stomach through the window provided by the remark-
able accident from which lie bad suffered. After he had

11«

THE BTOMAl-H.

been drinking freoly for several days, Dr. Beaumont
found the maeous mcmbraiio exliibiting inflamed and
ulcerous patches, and tlie secretions very greatly viti-
ated, the gastric juico being diminished in quantity,
viscid, and unhealthy, although St. Martin did not
complain of any unuif^ial feelings, and his appetite being
apparently unimpaired. The condition continued to
become still nmre aggravated for a day or two, when
the doctor found, to use his own words, that "the
inner membrane of the stomach was exceedingly mor-
bid, the crythematic appeai-ance more extensive, and
the spots still more livid. From the surface of some
of them exuded email drops of grumons blood ; the
aphthous patches were largo and very numerous, the
raucous covering thicker tlian common, and the gastric
secretions very greatly vitiated. The gastric fluids
extracted were mixed with a large proportiim of thick,
ropy mucus, and a considerable muco-purulent dis-
charge slightly tinged with blood, resembling the dis-
charge from the bowels iu some cases of dysentery."

It will bo remarked that notwithstanding the very
serious condition of his stomach, St. Martin was un-
conscious of any great disturbance there. This was
partly due, no doubt, to the paralyzing effect of alcohol
upon the nerves of sensibility. It is owing to this fact
that BO many suppose that alcoholic driuks have no
specially bad influence upon the stomach, when really
their stomachs are well-nigh useless from disease, but
too insensitive to indicate their condition.

The popular idea that beer, ale, and other similar
liquors are very nourishing, has been shown to be an
error. Alcohol is in no sc-nse a food. Professor

t 1

o be an I

ior Lie- ^^^|

UA^LADIES OF THS STOMACH.

117-

big, the eminent Gyriaan cliemist, haa shown by care- ■
fol analyais-that the amount ul nutriment contained in
a whole hogshead of the best German beer is less than
that contained in one ordinary loaf of bread.

Tobacco. — Not infrequently, though leas often
than is the case with alcoholic liquors, tliis narcotic drug
is recommended as a reraodj for dyspepsia. Neverthe-
less, in the case of tobacco, as in that of alcohol, the*
remedy suggested is itself an active cause of stomach J
disease. Only on the shnlVta simlllhits plan could
either one be reasonably employed. Both smoking and
chewing weaken and debilitate the digestive organs,
though both of these practices are thought by those who
indulge in tliem, to stimulate the process of digoaliou. [
This it probably doss for the time being, but only at
the expense of subsequent injury. Snuff-taking, espe-
cially, produces gastric irritability, probably by reflex
sympathy of the mucous membrane of the stomach with
that of the nasal cavity, which is irritated by the du-ect
contact of tlia acrid drug.

The idea that tobacco is beneficial because tif it
supiHJsed antisoptic properties, in tljat it may aid diget
tion by disinfecting the mouth, is without founda- '
tion, since the teeth of tobacco users are no less prone
to decay than tlmse of other people, and cancer of the
mouth, one of the most fatal and incurable of germ
diseases, is almost exclusively confined to tobacco nsere. ,
Tobacco users are also no less subject to pneumonia,
consumption, and other maladies, the germs of which I
ent^r the body through the moutli and nose, than are I
other people.

The immense waste of saliva occasioned by chewing' ]

THE STOMACH.

am) smoking may fairly be considered as one of the
means bj wLiicli the system sustains Ins^ and injury
tlirongli llie use of tobacco. An eminent physiologiat
reported the loss of several pounds in a week, as the
result of the stimulation of the flow of saliva by con-
stant mastication for experimental purposes. This ex-
plains the loss vf flesh in cases of tobacco using ; and
there is an equivalent loss of strength. It is apparent
that the loss of flesh is also in part attributable to the
physical damage of the body by tlie poisonous nico-
tine,— certainly a very doubtful sort of remedy.

Those who chew or smoke to prevent excess of fat,
should understand that any drug which will exert such
an influence upon the system must be a powerfully de-
structive agent. Those who succeed in keeping down
fat by the use of tobacco may depend upon it that they
are doing so only at the ruinous expense of their digest-
ive organs, and may look forward with certainty to the
breaking down of the nervous system.

Hard Water. ^ — So little attention has been paid
to this really common cause of indigestion by writers on
this subject, that we cannot forbear mentioning it here.
Experience has often proved that the use of hard water
impairs the integrity of the stomach eoouer or later,
when long continued ; and in numerous instances its
eflfects are almost humediate upon persons who visit a
hard-water district, having been accustomed to the use
of soft water. The cause of these injurious effects is
undoubtedly attributable to the lime and magnesia
which are contained in water called hard. These alka-
lies, as already seen in considering the physiology of
digestion, neutralize the gastric juice, and thus work

HALADIEB OF THE STOMACH. IIS

iiiifichief, Theru is little aeceBsity for the use of liard
water in any part of this country. Where there are
not Boft-water wella or springs, rain-water may be
caught and preserved in cidterns, and by boiling and fil-
tration through carbtm Ultere, made pure and palatable
for drinking and cooking purpoaes. Boiling hard water
greatly diminishes its hardness by precipitating the liine
wLicli it contains. There is no foundation for the theory I
that hard water is in any respect more excellent for nse J
than pure soft water. Distillation is the most efficient 1
of all means of securing pure water. A very convenient i
and inexpensive apparatus for distillation is manafac- i
tared by the Modern Medicine Co., Battle Creek, Mich.
Alkalies,- — For the same reason, soda, satcratua,
and the numerous compounds of these substances with
ammonia, alum, cream of tartar, etc., are all objection-
able on the same groui^ds as bard water. Being alka-
line, they antagonize the action ui the acid gastric juice,
and thus weaken digestion. There is no more active
dyspepfiia-produeing agent than soda or saleratus bis-
cuit, one of the miist common articles of food to be
found on the tea-tables of rich and i>oor in this country.
Doubtless well-prepared baking-powders are much pref-
erable to soda and civam of tai'tar or salenitus and sour
milk, mixed by the cook in accordance with the not re-
markably accurate "rule of thumb," through which
bungling chemistry the biscuit often present a golden
hue, which may be quite attractive to the eye, but gives
to the tongue quite too distinct a flavor of soda and pot-
ash to be agreeable to a fastidious taste, tci say nothing
of the probable effect npon a stomach not impregnable }
to the attacks of chemical agents. In baking-powders,

THX BTOlfAOB.

the various ingredients are so mixed as to leave nearly
neutral products, and yet these compounds are scarcely
j less pernicious in their inilueuce npon digestiOD then
the original chemicals from which they are formed.

The constitttonts of the boat baking-powders, when
mixed with water, are essentially tlie same as those of
Rochelle salts. Many baking-powders contain alum,
and nearly all contain more or less ammuuia. Both of
these substances have been shown to be ostremely det-
rimental to the digestive organs. Careful chemical
I tests made by the writer and by others, have shown that
ammonia, when used as a raising agent, is driven off
, by the heat only to a small extent, a sufficient amount
I remaining to occasion great damago to the digestive
, functions.

Alkalies of all kinds are injurious to digestion be-
toaaseof their neutralizing the gastric juice. Hypo-
I pep»ia and spepsia result from a long-continued use of
i alkaline substances in the food or for the relief of
Iflonr stomach, acidity, etc.

Perverted Appetites. — Strangely perverted
[, tastes, as shown in a fondness for earthy and other in-
oi^anic or innutritioua substauccs, while sometimes the
I resnlt of dyspepsia, are often the cause of stomach dis-
I orders. They are either the result of nervous or men-
I tal disease, or are adopted as a habit through example.
I In South America there are whole tribes of human beings
rvho habitually eat considerable quantities of a peculiar
Lldnd of clay. Several North American tribes have the
I same habit, being known as clay-eaters. A similar
I propensity eometimos appeal's among more civilized
I human beings, being almost exclusively confined, how-

? THB STOMACH,

ever, to youug women, cliiefly schoolgii-ls, who acquire
the habit of chewing up elate ptmcilB, and gradually be-
come BO fond of such earthy BubstanceB that they have
in BOme instances been known to eat very coneidorable
qnantiticB of chalk, clay, and similar substaaces.
While indicating a depraved state of the aystem, and
often of the mind also, this practiee has a. very perni-
ciouB effect upon tho stomach, wliicb is not intended, as
is that of the fowl, to receive inorganic matter of that
sort.

Tho amount of abuse of tliia sort which the stomach
will stand, however, is quite astonishing. Dr. Favy
telle a story of an American sailor who saw a jnggler
pretending to swallow pocket-knives With the char-
acteristic recklessness of a sailor, and supposing that
the knivea were really swallowed, he attempted to do
the same thing himself, and succeeded in getting down
four. Throe of these were passed off in a day or
two, but he never saw the other. Six years after, he
swallowed fourti-en knives in two days, aud was taken
to a hospital, whero "ho got safely delivered of his
cargo." lie was not bo fortunate on a subsequent
occasion, when ho paid dearly for his folly, lingering in
misery for some time until he died, when his stomach
was found to contain a namber of rusty knife-handles,
blades, springs, etc., the organ being greatly contracted
and corrugated in consequence of the violence which
had been done it. As a general rule, the innutritions
parts of foods, as the skins of fruits and vegetables, the
seeds and cores of apples and similar fraits, should he j
carefully separated from the nutrient portions, and dis- >
carded.

Adulterations of Food. — Tbe numerous adal-
teratioiiB of food which are now so extensively practiced
must bo recognized as a not unimportant cause of func-
tional disease of the stomach. Alum in bread and
in baking-powders ; lead in drinking-water which has
passed through lead water-pipes, or has been stored in
lead ciateruH, or collected from a roof covered with
sheet-tin containing lead ; lead occnrring in the tin cans
used for preserving fruit, or in tin pans or other tinned
ware, or in the glazing of kettle-s"; vinegar containing
flulphuric and other strong mineral acids ; pickles boiled
in copper or brass vessels, and thus poisoned with cop-
per ; sugar ma<le from corn, refuse starch, etc., and con-
taining irou, Bulphuric aeid, tin, etc.; flavoring extracts
3 by purely chemical processes, and amtainiug not
a drop of the extract of the fruit after which they are
named, — these, with numerous other equally li arm fnl
adulterations, may be reckoned among the active causes
of indigestion.

Unseasonable Diet. — Tlie failure to recognize
the necessity of adapting tLe diet to the season and cli-
mate is a prolific source of a certain class of dyspeptic
dworders. This is especially noticeable when the use of
large quantities of carbonaceous food, especially fats
and sugar, which may bo nsed in the winter with com-
parative impunity, is contiruied into the warm season of
the year ; or when a diet of this sort is continued in a
warm climate by persons who have been accustomed to
it in a cold country. It is this sort of transgression of
tlio laws of digestion that gives rise to " spring bilious-
ness," "bilious dyspepsia," etc., in many persons.
Large quantities of fat and sugar are not well tolerated

*■ THE STOM4CH.

by llie Btoruacli at any time ; and iu warm climates, and
in the witrui scasou of t-oUt aiirl tfrnperate latitndes,
they are exceedingly injurious.

Pressure upon the Stomach. — The stumacli
is remarkably sensitive to preBBure. It c\eu sometimes j
bceomea temporarily paralyzed by oxcees in eating, t
by the acenmnlation of gaa from fermentation, by the
distention of its walls. It ia eqnally liable fn injury of i
a aimilar sort fi-oni external eansee. A sudden blow .
upon the stomach has been known to produce almost .
instant death, through the impression made npon the
sympathetic nervons system.

The wearing of corsets, and tight-lacing with or
without fho corset, are common causes of dyspepsiii, as
well as of other Bcriima disoaacs. Wearing the panta-
loons drawn tight and without suBpcndera has a simi-
lar effed upon men. The soldiers of the Russian
army once suflfored so mnch from this cause that it be-
came necessary to correct the evil by a royal edict for
tlio purpose. Very soon after the evil practice was
discontinued, the effects disappeared. Bookkeepers
and school-children, from sitting at a desk; seam-
strcflses and tailors, from stooping over at their work ;
slioemakers, weavers, and washerwomen, from direct
pressure npon the stomach incidental to their work, '
are apt to sntfer from disturbance of that organ.

Tlio disturbances produced by compression of the
stomach, constriction ot the waist, or bad positions in
sitting are chicHy due to di^^plucement of the stomach,
resulting in too long retention of food, thus giving ex-
cellent opportunity for the development of germs .
taken in with the food, together with the irritating

acids and poisonoiiB substances wliieh I'esult from tiicir
growth.

Brain Work.— Moiitiil labor, if agreeable and
pleasant, is a mt)st healthful occupation. There is no
evidence for believing tliat brain work o£ that sort ever
disagreed with the stomach or Impaired its functions in
any degree ; but mental worry, discontent, anxiety, and
gloom are most unfavorable conditions for digestion,
and under thuir inSuenco few Btomachs can long main-
tain their integrity.

Lack of Exercise.— Idleness is one of the most
niihealthful of conditions. A lazy man 18 never well.
Exereine aids digestion by increasing the activity of the
diaphragm and the chest, as has been previously ex-
plained. It is also useful by purifying the blood and
aiding the vigor of the circulation. The detrimental
influence of idleness or a Bedentary life upon digestion
is very clearly shown by the results of such a life upon
the appetite. In a normal state the appetite is a good
index to the condition of the digestive organs, — in other
words, a good appetite means good digestion ; loss of
appetite means loss of tlio power to digest food. Out-
door exercise is particularly helpful as an aid to diges-
tion. Horselwck riding, bicycle riding, and rowing are
to be higlily commended.

Mental Impressions. — The digestive process is
very greatly under tlio control of the mind. The con-
nection between the mind and the stomiieh is so inti-
mate that Van Helmont maintained for a long time that
the stomach was the seat of tlie soul. By any strong
emotion the whole digestive apparatus may suddenly
cease to act. Fear, rage, and grief check the salivary

MALADIES UV THE E

secretioD, and without doubt the gastric nlso. Thnmgh
the miiid, the appetite may be eitlier encouraged or
quite destroyed. It seems very plausible that a strong
nei-vous impresaion might so affect the system as to lay
the foundation for chronic dyspepsia.

A man who sits down to dinner with his mind
depressed with business cares, the embarrassment of
debts, or the anxiety of doubtful speculations, cannot
hope to digest the most carefully selected meal. The
woman who dines with her muid disturbed with discon-
tent, fretfnlness, and worriment, is certain to suffer
with indigestion. Domestic infelicity may well he
counted as at luast an occasional cause of digestive
derangements. Meals eaten in moody silence are much
more apt ti.i disi^ree with the stomach than tliose which
are accompanied by cheerful conversation. A hearty
laugh is the very best sort of a condiment. Cheerful-
ness during and after meals cannot be too highly rated
as an antidote for indigestion.

Drugs. — The continued use uf drugs of various
kinds, and especially of patent niediciacs, "bitters,"
and purgatives, particularly the latter, has a very
damaging effect upon the stomach and bowels. Too
much eaniiot be said to discourage the use of laxatives,
purgatives, "liver pills," etc. While sometimes bene-
ficial, agents of this kind, if used for any leugtli of
time, are quite certain to work mischief. Purgatives
should never bo used except as temporary palliatives.
If the bowels require artificial aid, the enema is far
preferable ; and yet this jiljin also has its inconven-
iences, and results badly if too long continued. In
general, the less drugs are used, tho better. Patent

THB ETOUACB.

Dostruma should be Bliunned like tlie moat virnlent poi-
eons, as in mauy iustauces tliey are.

Alkaliiio laxatives and laxative mineral waters,
when used for any considerable length of time, are
exceedingly damaging ; they irritate the solar plexus
and induce hypopepsia.

Sexual Abuses. — Although thia is not the place
for a dissertation on the subject heading this paragraph,
sexual transgression in all its forms ninst be set down
ae 8 not infrequent cause of the class of disorders un-
der consideration. Secret vice in the yonng, thongh
often unsuspected, is tlie ondermining inflnence which
works irretrievable ruin in many constitutions, weaken-
ing the stomach by extmusting the nervous energies
upon which it depends for supptu-t. Marital excesses
have the same effect, and in essentially the same way,
the vital fiircTS being exhausted more ra|)iilly than they
can be replenished. The researches of Erown-Sequard
and his successors have shown that continence is not
only consistent with perfect health, but that the secre-
tion of the sexual glands is an ijnpoitant vital stimulus,
which is of great benefit to the individual, and indispens-
able as a cimtrolling element in the development of
the body.

Disease of Other Organs.— The nervona con-
nections of tlie stomach and its associated organs are so
extensive and numerous, involving, of course, equally
extensive and varions sympathies, that it is not a matter
of surprise that disease of other parts, through direct
aympathy, or through a general influence upon the wliole
system, often occasions disease of the stomach. This
ia so generally tme that it may almost be said that

MALADIES OF THB STOMACH.

l'2T

"■e-\cry disease liaa its accompanying dyspepsia." Tliis
fact is particularly observable in the weakness of tlie
digestive organs which usually follows prolonged fe-
vers ; wliicli accompanies and follows malarial diseases;
and which is closely connected with rheumatic and
gottty affections, with most maladies requiring enforced 1
rest for a great length of time, with moat forma of brain
disorder, and with nearly every form of organic disease,
as well as with structural diaeaae of the stomaeh, as
simple dilatation, chronic ulcer, contraction, cancer, and
other abnormal growth:*.

Inherited Dyspepsia. — Many patients asnert |
that tliey hnvo inherited dyspepsia from a dyspeptic i
father or mother, having sutfored from their earliest !
recollection from disti-ess after eating, or other disturb-
ance of the digestive functions. In many of these cases
there is douhtlcHS an inherited weakness of the stomach,
which may become genuine dyspepsia by a very slight
deviation from the lawa of good digestion ; yet it can
hardly be supposed that dynpopsia itself is inherited in
the sense that some itthcr diseaMCS are. Tho tendency
or predisposition may bo iidicritod in the form of a
weak stomach ; hut in most, if not all, of these cases,
carefnl inquiry will show tlnit the disease itself ia due to
bad feeding or some other mismanagement in infancy.
The use of nursing-bottles without proper attention to
cleanliness, which is indeed impossible when a long tube
ia oBcd ; tho employment of deceptive mixtures sold
88 "infant food ; " and especially the use of pai-egoric,
"Mi's. Winslow's Soothing Syrup," "worm teas,'' i
vermifuges, and other pnw(?rful drugs, with an infinite
variety of teas, sirups, and other patent and domestiQ

THE BTOM,

coinpomidH, — these are smne of the mtire powerful
inflnences which occasion early dyaiiepsiii, and often
entail lifelong misery and suffering. An individnal
who has grown up to manhood or womanhood under
the gloomy shadow of an ever-present, depressing, de-
spair-producing dyepeptfia, can never fully see the sunny
side of life, even if Lis stomach conld be made to do
its duty. The mind falls into habits of thought and
receives a certain cjist in eai-ly life that no inHiieuce of
after-years can erase. Hence a reai^nsibility rests
upon those who have t!ie eare of the diet of human
beings at the beginning of life which is really fearful,
in view of the immediate and remote consotjuences to
the victims of improper management.

A number of observations made by the writer have
led him to the conclusion that dilatation of the stomach,
a common condition in cases of chronic dyspepsia, often
begins in infancy or early childliood. The overfeeding
of children and the overd intention of the stomach with
gas, — the natural result of the Hse of candy, sweet-
meats, cake, and various other nnwbolesome and indi-
gestible foods, — frequently result in permanent injury
to the stomach, the consequence of which is lifelong
Buffering from indigestion and all the various inconven-
iences of constitutional maladies arising therefrom.

Undetermined Causes. — No donbt there are
many causes of disorders of the stomach which affect
it indirectly, through the nervous system, and have not
as yet been sutEciently studied to receive their due
weight. Among these may probably be classed such
influences as atmospheric or meteorological changes.
I have often met with individuals who, though having

r-j .' rj '( r.y « r.j „

-%Vr

♦>l( © ^) /<)

MALADIES OF THE BTOMArH.

129

no difficulty with digestion ordinarily, whenever a f alHiig
barometer indicated diminished atmospheric pressure,
and clouds covered the skv, wtnitd suffer great disturb-
ance of digestion. Similar results will, in some cases,
almost invariably follow the electrical distiu'bancea
which precedo and accompany a thunder shower.

■ Impure Water. — Tlie discovery of the fact that
most of the symptoms of indigestion are due to the de-
velopment of genus in the stomach and the influence of
the poisons which thoy pn>duce upon the stomach and
remote organs, through their absorption into the blood-
and their action npon the sympathetic nerves, has made
very clear the relation of impnre water to iligestiou.
Impure water always contains germs capiiblo of setting
up fermentation and putrefaction in food substances
within the stomach. Cold water taken into the stom-
ach checks the secretion of the gastric juice and the
process of digestion, thns giving the germs introduced
with the water an opportunity to set up fermentative
and putrefactive cliauges m the food, whereby are pro-
duced acidity, flatulence, biliousness, and sometimes
even nausea and vomiting.

The accompanying plate [ Plate II ) presents some
of the more common forms of germs with which the
modern science of bacteriology has rendered us famil-
iar, Plato III shows some of the numerous forms of
small organisms, animal and vegetable, which are to be
found in water obtained from nataral sources.

IMPORTANT NEW DISCOVERIES RE-
LATING TO DIGESTION.

Within the last twenty-five years, but especially
during the last decade, immeDse progress has been made
in the study of the disorders of digestion, and especially
in the methods of examining both tbo stomach as regards
its physical condition, and also the products of digestion.
This subject is somewhat too aliHtruee for the unprofes-
sional reader ; but a brief resume of some of tlie more
important facts relating to recent progress in methods
of examination of the stiDmach and iuvt^stigation of its
disorders can scarcely fail to be interesting even to non-
medical readers.

The most important discovery which has been made in
modern times in relation to the examination of the stom-
ach is the method sometimes termed "tubage," which
consists in introducing into the stomach a soft or semi-soft
and very smooth and flexible rubber tube. This tube is
not forced into the stomach, as was the case with the tube
of the old-fashioned stomach-pump, but is simply placed
in the mouth so that the end of the tiibo touches the
back part of the throat, whei-p, being grasjjed by the
muBclea of the throat in the act of swallowing, it is
quickly carried down into tlie stomach. By means of
the stomach-tube it is possible, by an actual measure-
ment of the quantity of fluid which the stomach will
hold, to form a very accurate estimate of its size. It is
also possible to dctermino whether the stomach empties
[130]

Hirw nrecovEBiBS kklatisg to diosstiow.

131

iteelf completely, and how long a time elapses after eat-
ing before tlio Btomacli has disposed of its food con-
tents by passing the digesting food along into the small
intestines. Many other facts relating to tlie work of
the stomach can be determined by tiiia means, but these
will be spoken of later.

Various methods have also been devised for deter,
mining the size and location of the stomach without the
use of the stomach -tube. One of the most ingenious of
these is the distention of the stomach with gas by gen-
erating carbonic acid gas in the stomach. For this pur-
poee the patient is first given bicarbonate of soda
dissolved in a little water, then tartaric acid, also dis-
solved in water. The meeting of tliose two sabstances
in tlie stomacli gives rise to the develiipment of a quan-
tity of carbonic acid gas. The quantity of chemicals
introduced must be varied eoniewhat, of course, accord-
ing to tlie age and the size of the patient. This method
is not very nmch used, however, on account of its incon-
venience, and the possibility of injury, especially in
cases of ulceration of the stomach, in which sorioas
damage might be done by a rupture of the weakened
stomach walls at the scat of the ulcer.

Another method of detj^rmining the position of the
stomach is that known as clapotement, which was
devised by a French physician. This method depends
upon the fact that agitation of the stomach when both
fluid and air are present in it, gives rise to plashing
sounds which can be easily heard by the unaided ear,
and can be very accurately located by means of the
Btethoscope. an instrument used also for examinatioo of
tlie lungs and the heart.

132 THE STOUACa.

Another method, which the author had the good for-
tune to discover a few years ago, is what might be
termed "simple palpation." By this method careful
examination of the stomiicU is made with reference to
the presence or absence of tiiiid. If plashing sounds
are not heard, then the patient ia made to drink water
as before. After the water has beeu taken, the physi-
ciaD, standing upon the I'iglit side of the patient, places
his right hand upon the abdomen just below the ribs of
the right side and to the right of the median line ; while
the fingers of the other hand are placed upon the cor-
responding point of the left side. Movements are then
made by the right hand of a character calculated to agi-
tate the contents of the stomach ; while with the left
band carefid observation is made of tlie presence or ab-
sence of the sign of "fluctuation." In case the patient
is not too flesliy, the movement of the liquid from one
side of the stomach to the other, resulting from the agi-
tation with the right band, gives ri«e to impulses which
ai'c readily recognized by the left hand, as the fluid set
ill movement by the right hand impinges against the
wall of the stomach, and communicates the impulse to
the abdominal wall of the opposite side. After some
practice the movements of fluid in the stomach can be
readily detected, and, by directing the impulses in va-
rious directions, the whole outline of the lower border
of the stomach may be clearly defined.

This method seldom fails except in very fleshy sub-
jects. In order to locate the stomach in these coses,
the author has constructed a special instrument, which
consists of a stomach-tube, bearing at its inner ex-
tremity a small electrical contrivance which is capable

J "

J_,^ Q

: ■BEHIIp

SEW mSCOTERlES RELATrSU TO DIOKSTION.

13»-|

of emittiDg a elk-king or buzzing snunii wlien excited 1
by an atteuuating electrical current. Passing the tube
and listening with the stethoscope while the
indicator is in poaitiou, it is very easy to determine the
lowest lUiiit to which the tube can be passed ; and by
making inuvements or readjustments of the instrument,
the outline of the lower border of the stoiuadi can be
very accurately marked out.

Tliis is llie method commonly employed by the
writer in making his examinations of the stomach. By
this method it is possible for one suftincntly experi-
enced to readily mark out the Incati-iu of the lower
border of the stomath in a few 8ec<mds, and to dis-

ir a prolapse of the stomach, dilatation of the etom-
ach, or a pocket iu the stomach, — conditions one or ,1
more of wliich are to be found in a great majority of I
* the cases of chronic dyspepsia.

The influence of tliese abnormalities in size and poaiK I
lion upon digestion will be referred to later. The ac-
companying cuts ( Plate IV ) are illustrations of a few
of the abnormalities which the writer has noted in his
examining office. In one of tlieeo cases, as will be
noticed, the stomach was prf^lapsed nearly to the pulws.
The colon, kidneys, and all the otiier viscera of. the
abdomen were likewise in a prolapsed condition. The
kidney^ in this particular ease, was prolapsed to such a
degree that ita function had been interfered with, and tfiJ
had become so badly diseased that it was foiin<l necessary i
to remove it. Within the kidney was fount! a stone
weighing four and one-third ounces. Tlie disease was
evidently the outgrowth of the malposition of the kid-
ney. Prolapse of the stomach and dilatation of the

134

THE erOUAOB.

Btomacli and colon are conditions to which too little
attention has been given. It is probable, also, that
prolapse of the bowels and dilatation of the stomacli
are Bometiines the result of indigestion ; but prolapse
of the Btoniaeh must certainly be, in many cases, the
cause of disturbance of the digestive function, being
itself the result of such mechanical cansoB as waist
constriction from corset- wearing, tight waistbands, or
the wearing of belts.

Examination of the Stomach Contents. —
The examination of tlie contents of the stomach ob-
tained after a test meal is of still greater importance
than a physical examination, — at least in the treatment
of functional or non-structural diseases of the stomach.
The stomach contents are obtained by means of a stom-
ach-tube, which has already been described. The pa-
tient is given a test meal consLntiug of one and one-half •
oancca of dry water-bread or two ooncea of oi'dinary
baker's broad, with eight ounces of water. Exactly
one hour from the beginning of the meal, the tube is
passed into the stomach und the contents withdrawn.
This is accomplished much more easily than might be
imagijied ; indeed, few persons suffer much from the
withdrawal of the test meal, although in occasional in-
stances the attempt to introduce the tube provokes a
spasm in the throat which renders the ])assage of the
tube impossible.

After obtaining the stomach fluid, it is subjected to
a moat critical and elaborate examination. The method
of exammation, which will bo more fully described, has
been compiled, arranged, and })erfected by the author

HEW DUOOTIKIBS BBI^TIItQ TO DIOK8TI0K.

from the investigationa in this direction by many otharfl
Bcientific workers. Some portions of the method i
quite now, being the result of the author's person)
work and experience. This is especially true in refer*
ence to the methods of determining coefficients, wtiichtJ
with the exception of one, have all been devised and^
determined by him.

The metliods employed in testing the digestion oH
starch, while not new to chemistry, have not been pre-9
viously employed in studying the disorders of digestion.B
The facta determined in this method of investigation^ I
which is more elaborate and thoroughgoing tlian anyl
other with which the writer is acquainted, will bo found
in a colored chart near the close of thin book, together
with the figures obtained in an actual case examined,
in which tlie amount of work done by the stoniacli was
greater than normal. This method of investigation has
been developed as the result of years of patient reseai-eh
and inquiry on the part of many different investigators
in different parts of the world. The foundation for the
method employed was laid by Dr. Golding Bird, of
Guy's Hospital, London, more than fifty years ago, in
the discovery that tlie acid of the gastric juice is hydro-
chloric acid, and that the degree of activity of the stom-
ach in the digestion of albtmien, is chiefly dependent
upon the presence of this atnd. The hydrochloric acid
of the gastric juice has been shown, however, to be notJ
simply the ordinary chemical compound known
hydrochloric acid, or muriatic acid, but an organic hy-J
drochloric acid wliich is possessed of much greater ao- '
tivity as a digestive agent in combination with pepsin
than is ordinary hydrochloric acid.

136

TBS STOMACH.

Dr. Bird's researches were vttiim a few ^ears re-
viewftl by Hayt-m and Winter, two French pliysiolo-
gi»ts, who perfected methods for determiiiiug not only
the amount of hydrochloric acid present in a given
specimen of gastric juic*, but the amount and quality
of the work done by the stomach in the digestion of al-
bumen. Ewsld, Boas, and other G€!nuan physicians
have contributed important methods for determining
other facts. Professor Roberts, of England, has estab-
lished a convenient method of studying starch diges-
tion. The writer, though not pretending to any s
eminence as a chemist or an originator of new methot
of study, has undertaken to combine these various n
ods, and by thu assistance of skilled chemists and the
advantage of experience in the examination of more than
five tliousand cases has perfected the method of study-
ing disorders of digestion herewith presented. A brief
explanation of the several facts determined by this
method will be of interest : —

1, The amount of stomach fluid is normally f
cubic centimeters, or one and one-third ounces ; thai
is, of the eiglit ounces of fluid and the one and one-hal
to two onnc-cs of sttlid food, taken into the stomach, i
with the oxcoptimi of one and one-third ounces, should^
be absorbed at the end of unc hour, or pass on i
tho snnill intestine. K a larger amount is fonud,
indication is slow absorption ; if a smaller one i
found, the absorption is more rapid tlian normal.

2. In tho examination of a large number of cas
tho average residue loft after filtration, is found to l
in healthy persons, twenty grams, or nbout one hi
the total fimonnt obtained. A larger residue than thia

SEW IliacOVBEIES RKLATINO TO DH5KSTIOS,

or a larger proportion of residue, indicates deficient
activity of the digestive fluids iu dissolving the food,
or delayed solution.

3. If the residue prusents masses of food of con-
siderable size, it is evident that mastication has been
insufficient.

4. Tlio presence of a large Hmonut uf miicns indi-
cates gawtric catitrrli,

5. A greenish or yellow color usually indicates
bile ; a red color, blood.

C. The odop of putrescence indicates decay ; a sour
odor indicates the presence of acetic acid.

7. A red color, or the presence of any unusual i
appearance, should lead to a careful microscopic ex-
amination by which the presence of pn9 oi' germs may 1
be readily determined. A thorough examination of J
the germs or microbes present includes a eiiltivatioa i
of the germs by mixing a few drope of stomach fluid i
with a proper culture medium, and subsequent staining ^
or microscopic examination by oi-dinary bacteriological
methods.

8. Tlio digestive agents which have been found
present in the stomach fluid are next investigated by i
means of color an<I other reactions, Those of the most '
importance are hydrochloric acid, pepsin, and the r
net or lab-ferment. Examination is also made for the |
presence of bile. If any of these substances are i
sent,. the effect is indicated by zero ; if present, by a '
simple + sign ; if in an unusual quantity, by -j- +.

9. Recent discoveries in physiological chemistry
have made it possible to investigate with almost per-
fect accuracy the different products of the digestion of

i;is

THE STOMACH.

albumen, or rather the products which are found in
tho different atagt's of the cnnversion of albumen
into peptone, the final product of the digestion of
albumen.

ll». By means of the reaction with a solution of a
coiu|)ound of iodine, a verj good idea may ho obtained
j-esjjeutiug the conversion of starch into dextrin or nialt-
Hugar, the reaction slmwing in succession the colors,
blue, violet, brown, and yellow while the change is
taking place, until the solution becomes colorless.

11. By methods which have been largely developed
in the Sanitarium Laboratory of Hygiene, it has been
found possible to obtain very definite data respecting
ihe amount of fennentatiou which may hsivo occurred in
iho case of any particular stomach fluid. Of the prod-
ucts of fermontnlicm fonud in the stomach, the most
common are lactic and acetic acids. Other acids and
alcohol, are, however, sometimes found,

12. Tlie above determinations are all of interest
and importance, but still more so are the more exact
determinations made by quantitative analyses of the
stomach fluids, whereby the degree of acidity is ac-
curately determined, together with the amount of chlo-
rin found in the different conditions, free, combined,
and fixed. The significance of this will be understood
by the simple mention of the fact that the gastric juice
depends, for its digestive activity, upon free hydro-
chloric acid, and that when fermentation ia not present,
the more strongly acid the gastric Juice, the greater its
digestive vigor, other things being equal.

13. Tlio det^irminations with reference to starch
have been undertaken on an extensive scale. At the

BIBCOVKKIKB BSLATINO TO DIGESTION.

139

present writing, these determinations have been made in
nearly one thousand cases in tlie Sanitariuui Laboratory
of Pljgicne, under tlie aatbor's direction. The deter-
minations made, are (1) with reference to tho saliva,
whereby the quantity formed and its activity are de- ■
termined ; (2) the amount of malt-sugar or laaltose, or i'
completely digestod starch, formed in the stomach ; (.^)
the amount of dexti'iu und soluble starch, or the im-
perfectly digested starch.

14. By accurate chemical methdds the total quan-
tity of acids resulting from fermentation, including i
lactic and acetic acids, is dctormined.

1."). A careful bacteriological study is made of the .
etomac-h jluid for the purpose of determining tlio num-
ber and kind of germs present, the number found vary-
ing from none in a licultliy stomach to many niillions in
an infected stomach. This I liave found to bo altogether
the most exact method of determining tho condition of
the stomach as regards infection and the resulting teu-
dency to fermentation.

Tlie experiments made show conclusively that fer-
mentation is not a natural process in connection with
digestion, and emphasizes the importance of suppress-
ing germs in the food, so far as possible.

The following facts are readily determined by this
examination : —

(1) The relative number of germs present.

i_2) Tho character of the germs, and the nature of
the disturbance which they produce in the stomach.

16. Most interesting of all are the determinations
relating to the coefficients of digestive work. These
coefficients are worked out from the data furnished by

140

I analysis. The indication 8 uf thes-e coeffi-

quantitative

cientB are iis followH

a. — -Tliia coeffick'nt indit-'ates tlie quality i>f the
work dune by tlio etomach in tho digestion of albumen,
The normal is l.Oi), as in the caae of each of the
eoefficienli. In tho present cwpe tlio coefficient is
found to be .S3, indicating that the work done by the
stomach in tlio digestion of albiunen was mncb below
jiar. Btill another fact, however, ia developed by this
determination ; the difference between the coefficient
and 1,00 indicates, in each case the proportion of
the vicious products of the digestion of albnraen formed
in the stomach and thrown into the circulation. With a
coefficient of .5U tho indication would be that one half
the albainen digeatod in the stomach was so imper-
fectly digestod as to be of no value as food, bnt con-
stituted, instead, a mass of poisonous substances which,
after absorption into the blood, must be destroyed by tho
liver and carried out of the body through tho kidneys.

b. — This is the coefficient of starch digestion, and
.indicates how nearly tho process of starch digestion in
tlie stomach approaches completion.

c— This coefficient indicates the degree of eEBeient
activity of tho salivary glands. It expresses both the
qnantity and the quality of, the saliva.

X. — This is the coetEcient of fermentation. It indi-
cates the relation of tho acidity due to abnormal acids
to the total acidity.

y. — This is the coefficient of solution, and indicates
the degree to which a given case approaches the normal
standard of twenty grama of residue to 40 e.c, or onq
!ind one-thirtl ounces, of stomach fluid.

^fii- 1

the 1

en. I

the I

TO DIOSSTION.

a,— TLia is the coefficient of absorptiou. It indicates
the quantity of fluid fouod, or its approach to the normal
amount. An excess of fluid indicates slow iibsorption.

m. — This coefficient indicates tlio degree of activity
of tho etoiuach in producing liydrochlorio acid, one of
the mosf important constituents of the gastric juice.

The abov§ data iu relation to the stomach fluid ob-
tained after a test meal hitvQ been determined in tbeJ
Laboratory of the Battle Creek Sanitarium, imder tho 1
author's snpervision, in more than five thousand caaea^ J
each one requiring more than fifty diflferent accnrately ■
executed chemical processea.

It is impossible here to enter into an elaborate di&"1
cussion of the bearing of all these important data upon 1
the functional disorders of digestion and tlie treatment^
of those disorders. The reader will, however, be able 1
to see at a glance that accurate d etc I'mi nations of this I
kind niwit render poKsible b more exact adaptation oi\
remedies and diet to individual cases than is possible 1
witliout such definite and precise information.

Twenty years ago, when the writer was starting out
in the medical profession, one of the greatest difficulties
and embarrassments wliich ho encountered, was tho
lack of definite information respecting the disorders of
digestion and the adaptation of remedies to their relief.
Prescriptions, diet, treatment, and regimen were almost
altogether matters of guess-work or intnition ; and, in„
many cases, the only way «f finding out whether the I
patient required one dietary or another, was to experi-
ment upon bim. A recognition of this fact caused an
eminent Kew York physician to declare that every doso
of medicine was a blind experiment upon the vitality of

142 THE STOMACH.

the patient. A new case of chronic dyspepsia waa
always encountered witli dread, on account of the tedious
experimental proceBs, painful alike to bntli physician
and patient, whic^h must bo gone through in the dis-
covery of just the dietary and the treatmiiiit best adapted
to the case. By means of the present method, however,
it is possible to obtain sui'h accurate information that
treatment and a dietetic prescriptiim may bo made with
full confidence that the patient will he afforded definite
and prompt reliuf.

One of the most important advantages gained by
this precise nK^thcJ of analysis is the possibility of
making an exact and definite classification of all the
functional disorders of digestion. In relation to this
new classification, it may bo said briefly that, considered
in relation to the amount of work done, there are four
general classes of indigestion, — h^pfrpepslii, in which
there is excessive stomach work ; hypopepaw, in which
there is deficiency of stomach work ; apejisiu, in
which there is no digestive activity whatever ; and
niiitple d;/Mj}tpst'a, in which the amount of work done
by the stomach is normal, the change in tiie stomach
work being qualitative rather tlian quantitative. By
these studies I have been enabled to subdivide these
several classes as follows : —

ITyperpepaia, into three principal classes and twelve
subclasses.

Hypnpepmi^ into two principal classes and eight
subclasses.

Apepaia, into two subclasses.

Simple dyspepna, into four eubi

mW DtRROTBRIBfl aXhATUfa TO DiflssnoM.

143

TliiB mak(!B twenty-eix difierent varieties of mdigea-
tion, eairii with its individual charaeleriaticH.

In tbe results of the Btndy of over five tbonsaDd
analyses made with painstaking accuracy by the methods
which I have very briefly described, I have not foond a
single case which did not fall in one of the classes
named, and have found examples of every class.

I give, in the following pages, an abbreviated out-
line of the classification, together with a brief outline
of the data determined by the thorough investigation
of the work done by the stomach which the modern
advances in chemistry and bacteriology render it possi-
ble to make.

It must not, of course, be supposed that the treat-
tnent of disorders of digestion can be made, even by
these exact methods, in any way mechanical or routine,
since every individual case presents peculiarities which
must be taken into consideration. The withdrawal of
the contents of the stomach in the midst of the proc-
ess of digestion, enables us to surprise the stomach at
its work, and thas to detect special faults, such as ex-
ecus or deficiency of activity, abnormal fermentations
through the development of germs in the stomach,
etc., and thus makes clear much which has heretofore
been a mystery, or a matter of pure spc>culation in
relation to the disorders of digestion. Nevertheless,
the size, shape, and location of the stomach in relation
to normal conditions, and many other details, must be
taken into consideration in formulating a prescription.

CLASSIFICATION OF FUNCTIONAL DISORDERS OF THE STOMACH

IN RELATION TO PROTEID DIGESTION,
Bucd upon I QuantlUllvc Chemical Eiunliution of the Stomach Flald

The symboU under each head indicali; the characlerislic
each indiviiiual form of qimnliulive disturbance to which the
slomach i« subject.

HTFERFEFSU. A" +.

. A' + H + C+TypicftW

1 1.

_ 1 1. Without ferm'n
- (2. Wilh

1 I. Withoui ferm'n
~t2. With
_J 1. Without (erm'n
" i 2. With

) I. Without ferm'n
"ja, Wilh
_i 1. Without ferm'n
- ) 2. With

) I. Without ferm'n

J 2. With

L-E(rO).
,'n(«0)..

HTPOPEPSU. A'-

1 1. Without ferm'n
\ 3. With

i 1. Without ferm'n
i 3. With

1 1. Without ferm'n
) 2. With

j 1. Without ferm'n
1 2. Wilh

AJPEPSIA. A o

SUKPLE DTSPEFSU. A --

I 1. Without term'n'f

) 3. With

i 1. Without ferm'n't'n (* I

j 2. With ■• (»■

HEW DIBCOVBSIBH RKLATINO TO DIOB8TION. 145

RESULTS OF 8U»UTJIIVE HO COJNTlTAmE DETERBINJ-
HOBS RELATIKG TO SHIVAHY DICESTIOM A«D THE STOI-
ACI FLUID OBIAMED AFTER A TEST lEAL.

Cue Tia...S2a4..

H/m B D»to. . . .Jag. S5 189.5. .

Tert HmI.— Regular Test BfeakfBst

Time of Digestion r h f3 m.

PnrSlCAL AND MICROSCOPICAL CHAKACTERS.

Phj'SiCAl. NarmBl.

Aniimiit..95..c.c. (Wc.c); Disintegration. .+..; Color. ,b, .

Residue. . 25. . gfins. <20grmB.): Mucus. . .0. . , ,: 0(ior..». ,
Mierotwnpical.— Blood ; Pub ; Misc ; Bacterini

COLORESETEIC ANB OTHER qUALITATITE REACTIONS.

DIOESTn-S AOBNTS.

FreeHa Congo Red.. + .. RosorCLnc.. + .. Dried Ite.sidue. . + . .
Pepsin Reimet Ferment. + .. Rennet Z}'inuKeii.+ ' ftile.ff..

, Pi-plcr

Prot*Mg. — Syntonin., ..-}-.. Propeplor

Albuminoids. .+. .
Starch (Lugol'sSol.), Blue, Violet, Brown. Yellow, C.ilorless

PEBMEKTATION- PBODircTS.

l.iictlo Acid + 1 Acetic

Aleohol Volatile Acids i Butyric . .

Misc ■ ( Formic . . .

QCA-vnTATin: CHEancix determisatioss.

.grms. (.ISO-.aOOgrms.) 'If
■' A'
, " {.300-.330 " )
. " (,025-.050 " )ff
, '■ (.155-.180 " )C

. ■< {.loo-.m '■ )^

ToUlafldilj, lA) 314..

C»letiiated«ddilj,U)" .382..

ToUl chloriu, (T) 390 .

Free nCl,(Hl 04S..

Combined ehlorln, (C). . . .330. .
fixed cUoridSftF) 032..

THE STOMACH.

DlSSsnOI* OF BTABCB.

Sollra, Btn't in 5 m. .H.-grmB. (1 c.c.) converted .1 grm. m..t3..m.

SUItow, {M ) 1.424. . . .prma.

Dextrin and Solable Slarch (D) S.9te. ... •■

Fattj Adds (from fermentation) (L) 005.... ••

(Lactic acid.,.ffOff. .grins. Volatile acids grms)

COEFFICEESTS OF DIGESTITE WOBK.ft

Outrto J ProWds {<i) S3. . . . FermenUOon (r). i

Dlgextlon Uurcli ('<) 24.... SuluUun (v) r.M.g

SaUvarr AcUiltj (c) 42.... AbMrpUon i'). . . .

(wniclpnt of Chlorin Liberation (m) r.5« ^J

Froteld Dlsestlon and Add Fermentation (i and z)

• The acidity (A and AT and the qnantltles at chlorln In the differ-
ent torros Dt (T), (H), (01, aud (F>, are expressed as UCI. The valaea given
relate to luo e.c. of sMmauh fluid. The amouat of tatty acld!i. chiefly
lactic (L>, is eiprossed in graiuEi ul HCl. vblch should Iw multlplJL'd

tcid pi

. The

ulpressad to

tose (U), as well aa that of soluble starcli and dextrin (D). Is
grams of equivalent dextrose.

f By noting tlie sIkd tolIoKing the symbols Id this colamn and co-
ef&ciouts (a) and U). and reterring to the claaalflcatlon. the diagnosis of
any case In relation to proteld digestion and feraieatation luuj be easUy
made. By transferring the figures to the blnnli tor ■' Graphic Bepresen-
tatlon," the indicatlous will be seen at once, the analysis thus furolahiDg
A basis for rational treatment and the proper dietary.

** The calculated acidity (A*} Is determined by the foUowIng (armnla:
C + H - L = A'.

ttThe nomuil amount of irorlc Is. In the case of each coefficient, ret>-
reMnted by 1.00. The flgares iiiTou usually represent the percentage of
deviation from normal. The coefficient of fermentiitlon represents the
number of mllilgramsof lactfc acid nr combined tatty acids toQDdtDoach
100 c.c. of stomach fluid (expressed in equivalent HCD.

The sign -]- indicates presence in normal rjuantily : ++ '*>
excessive quanlily; — in dcflci>'nt quantity; (zero) wholly

As regarde the relative frequency of tlie different
classeB, Bimple dyspepsia ia the most common of all.
Apepsia is quite rare. I have met less than fifty caBes

irew mscovBHiis kklatmq to diobsttos.

in more than five thousand, or a little less than one
per cent. Hypopepsia and hyperpepsia are about
equally frcqu«nt.

As regards recognition of these various classes by
Byraptome alone, I am sorry to be obliged to say that
it- is impossible. A test breakfast and a careful ex-
amination such as I have described is absolutely
essentiul to a precise diagnosis of the functional dis-
orders of digestion. One who has studied a large num-
ber of cases by the methotl described, may, by a careful
study of the symptoms, sometimes form an approximately
corret^t judgment in respect to the nature of the case
in hand without making a chemical examination ; but
positive information can be obtained by no other
method than by exact chemical analysis. A few p(nnts
relating to symptams are worthy of mention, as fol-
lows : —

In hyperpejma there is an excessive secretion of
gastric juice, in connection with which there is usually
a good appetite, but an escegsive irritability of the
stomacli, as is ehown by the tenderness elicited by
pressure at the pit of the stomach or just at the lower
end of the sternum. Other symptoms due to excessive
irritation of the gastric mucous membrane are also
more common than in simple dyspepsia, hypopepsia,
or apepsia. Acidity not due to fermentation is co
monly present in extreme cases of hyperpcpsia. This ■
form of acidity develops soon after the taking of a 1
meal, gradually increasing until the food is expelled
from the stomach into the intestines three or four
hours after eating, or until the acid contents of the
stomach are washed out with a stomach-tube, diluted

148 THB BTOHACH.

by the drinkiDg of water or some other fluid, or some-
what modified by the taking of moVe food, or neiitnilized
by soda, carbonate of magneeia, or some other alkali.
PatientB suffering from hyperpopsia are often fleshy
and florid, altbougli not infrequently they are quite
thin in floeh.

In hyjMipepnia there is often a lose of appetite,
general feebleness, pallor, and more or less pronounced
symptoms of indigestion, with anemia, or an impover-
ished condition of the blood.

In ajwpsia the symptoms of hypopepaia are very
much more pronounced.

In 8imj>h dyspejintti the principal symptoms may
be simply weight at the stomacli, and evidences of
fermentation.

In caso of fermentation, whatever other symptoms
may be present, the bacteriological examination shows
germs of some sort present in great numbers. In
one case investigated in the Laboratory of Hygiene
connected with the Battle Creek Sanitarium (Mich.,
U. S. A.), the stomach fluid was found to contain for
each ounce, more than 16,437,300 yeast cells. Other
germs were entirely absent. By the aid of this investi-
gation it has often been possible to make an immediate
and successful application of appropriate remedies,
which, without this method of learning the exact con-
ditions present, could only have been reached by a
long and perhaps disappoiuting experimental effort.

SYMPTOMS OF DYSPEPSIA.

As Dearly every disease may includo amoug its I
symptoms some disorder of digestion, so dyspepsia maji
include in it8 symptoma some of those of nearly everyfl
disease t)i:tt could be named. TLia is readily uuder-'f
Btood when we consider the fact that impairment oiM
digestion interferes with the nutrition of every organs
of the body. Every part suffers, and of course the
suffering organs express themselves in the various
symptoms by which they manifest diseased or dis-
ordt-'rud functions. The particular features manifested
in any given case will differ with individual peculiari-
ties of constitution or temperament, which give promi-
nence to some particular set of Bymptoma which may
or may not refei* to the stomach. As a usual thing,
however, there are certain symptoms which refer di-
rectly to the stomach, and which are generally nndor-
stood as indicating disordered digestion. The intensity
of the symptoms manifested varies from the slight un-
easiness and sense of weight or fulness occasioned by
a small excess of eating, to the most distressing and
painful condition of the more aggravated forma of the
diBorder.

When possible to do so, the treatment of every

case of disordered digestion should bo preceded by a

careful examination of the stomach fluid, which gtves

information ubtainable in no .nher way, and which can

[1491

150

bt Fcfied mpi» aft oacL b is i
dat Ae paCieat iteaU visl a labonoorjr in order
. be made. ICoct modem phj-
tnbaa, and
tha test braakfmt and remore tiie
I flaid at As proper tune, place it in a clean
bottle, car^nllj leal and padi the same, and send it
hf e»p t c e B to a labocatDrr in vbich each examinatiODs
are made. &COraacli fluids usnall/ keep witboat ma-
terial dtto^ for some little time. (For diractioofl for
teat meal, see page 131.)

As tbia vork is especially inteDd«d, Itoverer, for
persoDs vbo are bo situated tbat tbcy canuot arail
themselves of skilled mMlicid advice, and siDOe
home treatment of this disease must be largely sym]
tnatic, wc pre^icni a siiuplu cla^itication based
symptoms, and a detailed account of the principal
symptoms of dyspepsia, together with the best mediods
obtainable at home for tlie core of tbe disease.

Classification of Indigestions. — Djgpepaia
may be classified, first, as acute and chronic One of
the most important differences between an acute and a
chronic ca&e of indigestion is that in acute dyspepsia
recovery will occur in time, usually in a very short
period, by the unaided efforts of nature ; while a chroni^'
case of tbe disease continues from bad to worse,
without material improvement, indefinitely.

Most cases of acute dyspepsia are the result
excess in eating, taking food at an unseasonable hoar,
the partaking of unwholesome and indigestible sul
stances, or the accidental swallowing of some hig]
irritating substance, as poisoned or decayed food,

irail I

SYMPTOMS OP- DYSPEPSIA.

151

soma similar iiritant. Tho majority of these eases
recover spontaneously, and so qaickly tliat they scarcely
need further uttentiim in this cunnection.

Chronic dyspepwiji is generally much less active i
its symptoms than is the acute form of the disease, Itt^
usnally begins slowly, making its advances insidiously,.!
and thus for a long time eluding observation, in many
instances until well established. This is one reason
why the diagnosis of the disease is often obscure.
Very frequently it is overiookud for years, being mis-
taken for some other disease through the special promi-
nence of symptoms elsewhere than in tho stomach.

Basing the classification of chronic dyspepsia upon
the most prominent symptoms observed in different
cases of the disease, by far the greater proportion may
be included in the following five classes ; viz., simple,
acid, septic or bilious, painful, and nervous dyspepsia.

Each of the classes named has its characteristic
symptoms, though any given case may combine the
symptoms of one or of all the different classes. After
a brief consideration of the most important symptoms
relating to the etomach which appear in different phases
of the disease, we will consider the special symptoms,
or groups of symptoms, which characterize the differ-
ent classes of dyspepsia mentioned.

Principal Symptoms of Indigestion. — Tlie
different symptoms observed in the disorders of diges-
tion arise from —

1. Disturbance or irritation of the nerves of the
stomach.

2. Disturbance of tlie muscular apparatas, or motor
functions, of the stomach.

IBfi TllB STOMACH.

3. Diatnrbanco ff tho secreting, or glandnlKr,
fanctions of the Btomacli.

4. Change in the size ami location of tho stomBck,
as in dilatation and prolapse.

In addition to these, there are also physical eymp-
toma relating to the tongue ; Bymptoms pertaining to
the evacuation of the stomach and bowels, vomited
mattera, and stools ; symptoms which pertain to the
rectum ; and various general and remote symptoma
which are the outgrowth of tlie diaordora of digestion.
A brief enumeration of the most important of these
symptt»mB may bo found of practical interest. They
are presented here in the order in which the writer
commonly notea them in the examination of a patient.

Symptoina Pertaining to the Moath. — 1. Morbid
sensations — stinging, burning, loss of taste and mor-
bid tastes, such as metallic, acid, eweet, or peppery sen-
sations ; 2. Secretion — viscid, scanty, or in excess ;
3. Mucous membrane — small ulcers, red points ; 4.
Breath — sour, fetid, fecal ; 5. Coated tongue.

Symptoms 1'erfai.tiing to tite Thnmt. — Excessive
tliirst, dryness, irritation, cough, choking.

Symptoms Pertaining to ths Rnyphagust. — Symptoms
of burning, constriction, or a feeling of a ball or lump
in the throat.

Symptoms Pertaining to the Stomach. — Symptoms
arising from disturbance of sensation — distention, con-
striction, heaviness, burning', coldness, senaation of ful-
ness, beating ; abnormal hunger, — constant, sudden,
and nn controllable, frequently requiring food between
meals ; appetite excessive, diminished, variable, de-
praved, absent, but returning after taking a little food.

BVUPTOUa OF UV8PWBIA. 153

increaeinK 'with meal, insatiable, craving for special
foods, diBgast for certain foods ; naaeea ; pain.

Dutwhancea of the Motor ^u/iciio;;^. — Kegnrgita-
tion of food, rnmination or merycism, eructations of
gas, vomiting of fluid, food, blood, pus, bile, or mucus
(either with or without nausea)', burning, dull, or sharp
pain ; faintness ; pain on eating.

77ie Discharges. — -Vomit, — blood, pus, bile, curd,
bitter, sour, odor of decay; stools, — hard, soft, or
balls, ragged, acid, very foul, black, clay-colored,
watery, oily, mixed with mucus, bloody ; parasitic
worms; constipation, diairhea.

Syviptoma Pertaifung to the- ^f<'<i»w,^ Painful
stools, burning pain after Btool, loss of desire to evac-
uate the bowels, anal itching.

Gcnernl Ncri'oaa Symptomn. — Nervoneness, morbid
fears, depression, loss of memory, lack of energy,
inability to concentrate the mind, mental confu-
sion, dulnesa ; disturbance of apeecli, aa stammering ;
fidgets, iiTitability, insomnia, loss of self-control ;
drowsiness constantly, or after meals ; headache at the
back, front, top, or side of the head, affecting one or
both eyes, constant, periodical, or occasional ; sensation
of heaviness, constriction, or discomfort in the head, legs,
arms, or other parts of the body ; sensation of abnormal
size in arms, head, or logs ; strange sensations in the
eyes, as strained feeling, a feeling as if bursting from
the sockets or sunken in tlie sockets ; desire to support
the back of the head ; pain in the scalp or in different
portions of the spine after drinking or meals ; pain
between the whonlders ; pain in the lower part of the
back j pain between the ribs or under the ribs ; giddi-

154

THB erOMAOH.

ness, vortifro ; partial or oiiiplete liiss of conBcionsneas
duo to suddou fi'ight or hoiuq strong impression ; seiiaa-
tioti of ligbtuess in tbe head ; disturbing dreams ; sudden
awakeuiug at night with constriction of chest, with
difficult breathing or heavy beating of the heart ; ''ex-
ploBtone ' ' in the head ; coldness between the shonlders ;
coldness in hands and feet or knees ; sensation of shiv-
ering or burning after eating ; ringing in the ears ;
disturbances of vision, unnatural colors ; disturbance of
smell or taste ; abnormal sensations, such as nnmbness,
tingling, burning, etc. ; sndden loss of strength ; trem-
bling and twitching of muscles ; constant weariness ;
palpitation of tiie heart ; irregular sensations of the
heart ; sensation of constriction or heaviness about
the heart ; shortness of breatli ; nervous asthma ;
stomach cough ; hiccough ; inviiluntarj sighing ; cxces- i
sive quantities of nrine of liglit color ; seamy urine ; too |
frequent urination ; whitish or reddish sediment in the
nrine.

Phijuicol Slgna. — Physical examination shows in a
large proportion of cases of chronic dyspepsia, dilata-
tion or prolapse of the stomach (see page 317 and Plate
rV). This condition is often indicated by an nn-
natural plashing sound heard by the patient in walking
or other movements, especially after drinking water,
and by unnatural prominence of the lower abdomen.

All the above symptoms and many others of less
importance are observed aa the rusnlt of disordered di-
gestion, although of course all the symptoms named
are not present in any singlo case.

THE SYMPTOMATIC TREATMENT OF
INDIGESTION.

Uneasiness at the Stomach.— Oue of the

most cummoQ symptoms, aTid one which is frecjiieiitly
the &rst noticed by patients, is an uneasy sensation in
the stomach, which ia variouaiy dcacribed as fulness,
weight, tightness, oppression, heaviness, heat, cold,
pulling, "a load on the stomach," ditiwing, "work-
ing," etc. There may or may not bo tenderness on
pressure at this stage. Tlio uneasiness complained of
is greatly increased by any excess in food, and may be
occasioned by even an ordinary amount, by eating too
rapidly, by drinking at or soon aftur meals, or by eating
articles of food which are dithcult of digestion, as warm
broad or biscuit and butter, pastry, fried food, pickles,
etc. The essential diiference between this condition
and that resulting from eating to excess in health, is
that the symptomB described are produced by an or-
dinary and proper amount of food, being only increased
in severity by excess in quantity.

These symptoms are all due to an increase of the
irritability of the gastric nerves. They may be caused
by the use of alcoholic liquors, tea and coffee, ice-cream,
iced drinks, too frequent eating, and the use of condi-
ments, as mustard, pepper, pepper-sauce, liorseradish,
Worcestershire sauce, and in some cases by the use
of raw onions, radishes, and fats.

[155]

156

THK STOMACH,

Tnntiiiriit. — Tlicae symptoms are generally relieved
by an aseptic dietary {Diet List No. 1). In extreme
caseB the dietary should be confined to well-disintegrated
foods (Diet List No. 7). In very obstinate cases, a
liquid diet (Diet List No. 11 ) or a milk diet is indicated.
All foods difficult of digestion (Diet List No. 22) should
be avoided when there is fulness, eructations of gas, or
acidity. All foods which proiaote fermentation (Diet
List No. 23) should be carefully avoided. A fomenta-
tion (10) should be applied over the stomach and abdo-
men at night, followed by a wet girdle (9) to be woro
during the night, and the dry abdominal bandage (44)
during the day, witti nutritive treatment (page 331), eleo- i
tricily (65, t>7, 69), Swedish movements (39), and sub- ,
carbonate or subnitrat© of bismuth (62). In casea of
prolapsed kidney, or in extreme cases in which acidity
occurs within an hour or two after eating, especially
when there is a suspicion of ulcer of the stomach, bicar-
bonate of soda (64) may bo used in ten- to fifteen-grain
doses before each meal. The Natural Abdominal Sup-
porter (45) is requu-ed in cases in which relief is ob-
tained by upward pressure with the hands applied to the J
lower part of the abdomen.

Flatulence.— This symptom indicates the presence ^

of gas in the stomach or bowels, the character of which l

varies greatly, sometimes consisting of air which baa |

been swallowed with the food in hasty eating. Some>

times, also, persona acquire the habit of swallowing i

air, OS do horses, in which the habit is known as '

"cribbing." The act requires quite a strong effort,

yet it is sometimes practiced constantly by hysterical

patients, and sometimes also by dyspeptics to relieve

SVHFTOUATIO TBBATMZNT OF IKDIOSSTION. 157

unpleasant sensationB at tbe etomacb. A Bmall qnan-
tity of air is EWallowed in the act of golping, which
usually occniB just before vomiting, and can be accom-
plished at will by most persons.

The usual cause of gaseous distention of the bowels,
however, is the formation of gas within the bowels
themselves, by the formontation of starch or sugar.
Sometimes tliia occurs to an enormous extent, giving
rise to belching and eructations, well compared to
roaring in extreme cases. In some cases, accom-
panied by hysterical manifestations, the accumulation, i
of gas will be almost instantaneous. In these cases ]
the air may be swallowed, or regurgitated from the
small intestine.

It is probable that flatulence, or distention of the
stomach with gas, is sometimes due to the secretion
of gaa from the blood. It seems to be rapidly thrown
out in great quantities in certain cases, particularly
in nervous disease of the stomach.

When caused by fermentation, the gas usually con-
sists eliiefly of cai-bouic acid, from the destruction of
starch and eugai', and is both tasteless and odorless.
At other times it contains sulphureted hydrogen and
other foul gases, from the decomposition of the albu-
minous and fatty elements of the food throngh the ao- j
tion of germs.

Intestinal flatulence, giving rise to rumbling in the
bowels, or borborygmus, has the same causes as flatulence
of the stomach. Tlie form of flatulence which affects
chiefly the small intestine seems to he in a gi-eat degi-ee
duo to deficient secretion of bile. It affects chiefly
weakly persons, those greatly debilitated by chronic

158 THE PTOMAOH.

rhemnattBin, «-iipecially, and more often women than
mPu. It is frequently a cause of aleeplesaness, and of
uiipl^anaut and erotic dreams, ginng rise to nocturnal
lossoH iu persons whose sexual organs are in a weakened
condition.

Flatulency of the colon, or large inteatine, occa-
sioning offensive gaseous discbai^eB, arises from the
det-<itnix)sitioQ of the retained contents of the bowol.
It occurs most frequently as an accompaniment of coii-
stipHTiou, and of a deficiency of bile. This condition ia
0B]ieciully noticeable in cases in which a mixed or a
iiKiat diet has been used, in consequence of the decompo-
siliun of portions of undigested meat, which takes place
in the colon. In cases uf this kind there is constant
poisoning of the system through the absorption of boI-
ublo poiaoiiB which are formed in connection with the
offensive gases.

Tfratment. — Temporary relief from flatulence may
generally be obtiuued by sipping a little very hot water,
either with or without a few drops of some volatile sub-
stance, as camphor, peppermint, or ciimamon. The
hot water-bag over tbo stomach usually gives relief if
there ia much distention with the flatulence. Perma-
nent relief from this condition can be obtained only by
employing an aseptic dietary (Diet List No. 1). It is
generally necessary to discard all articles difficult of
digestion { Diet List No. 32 ), and those which are apt
to promote fermentation ( Diet List No. 23 ). In cases
in which starch is digested only with difficulty, farina-
ceous foods (Diet List No. 4) must be avoided, and
a nitrogenous dietary should be strictly adhered to for
some time, with tonic water treatment ( page 333),

TREATMENT OF INDIGESTION.

159

electricity (65, 66, 68), maesage (30, 31), Swediab
raovemeiita (42), and daily exercise in the open air.
Charcoal tablets (47, 48, 49) shonld be taken after
each meal.

Fermentation. — Septic and even pntrefactive
changfs may take place within the body as well as
outeide of it. According to the conclueionB arrived

at by careful scientific iuvcstigation, the process of fer-
mentation consists of chaagos in organized substances
induced by germs roccivud fiom the air. There are va-
rious kinda of germs, which induce different forms of
fermentation. A variety of oiganisms known as yeast,
excites the fermentation by means of which bread is
raised, beer and wine fermented, etc. Through the
11

THB BTOMAOH.

action of yeast, sugar and starch are first converted into
carbonic atid, aliioliol, and water.

It is this kind cf fernn;ntatiou which produces that
form of flatulence in whicli the stomach is distended
with a tasteleBfl and odorless gas. In tho stomach,
ihe pritcesa ia precisely the same as in tlio baker's
dough trough or tlic beer vats of the brewer. Wlion
digestion is promptly jwrformpd, the food is digested
and absorbed before it has time to ferment; but when
it is slow, either un account of deficient muscular
action on the part of the stomach, or because of ile-
ticieiit or defective secretion of gastric juice, fermenta-
tion takea place before digestion ia completed. The
eonditiouB of the stomach are then peculiarly favorable
for the occm-rencG of fermentation.

This change would always occur iu the stomach
were it not foi- the preservative influence of the gastric
juice, which, when hydrochloric acid ia present in suffi-
cient quantity, effectually prevents fermentation by de-
Btroying the germs which enter through the mouth, or
which are ordinarily taken in the food. As befoi-o re-
marked, however, if digestion is delayed for any reason,
the germs taken in from tlio air or with the food quickly
excite fermentative changes, and gases and various
poisons are developed.

Bacteriological experiments conducted in the Lab-
oratory of Hygiene of the Battle Creek Sanitarium
(Michigan, V. S. A. ) for the purpose of studying the
nature and action of germs found in the Btomach, have
shown that the healthy Bti>mach is capable of destroying
the germB which enter it iu the art of eating, providing
the food itself is sterilized ; Ihat is, before being eaten

it is heated to a temperature snfficiently higli lo de-
stroy any germs which it may contaia. This is found
to be true, at least in the case of granose, a thoroughly
sterilized fotxl. In nine stomach fluids obtained after
eating granose, germs were found in only two cases,
and then very few in number.

Raised bread and ordinary biscuit always contain
quantities of yeast germs in their interior which hav6_^
not been exposed to a sufficiently high teniperaturo to j
destroy tlieir vitality. When taken into the stomach, 5
these germs grow and develop, producing fermentation.
Various yeasts, the spores of which are always to bo <
found in flour, and which give rise to fermentation in the
presence of warmth and moisture, occasion in tlie stom-
ach the alcoholic fermentation by which carbonic acid
gas is produced in abundance, and even sraall quanti-
ties of alcohol. Other germs give rise to acetic acid, or
vinegar fermentation, in which the alcohol produced by
the action of yeast germs is converted into acetic acid.
Other germs produce the lactic acid, or sour- milk fermen-
tation, and still others give rise to a butyric-acid fermen-
tation, the fermentative change which occasions the
rancid flavor of strong butter or decomposing fats.

All of these fermentations may take place at tha
same time. While the healthy stomach is able to de-
stroy a few germs, the quantity of germs introduced '
with the food may be so great that even a healthy
stomach cannot destroy them all. This is likely to be
the case in the use of cheese, m;.-at which has acquired
a "high" flavor, sauerkraut, and such unnatural foods
as oysters, either raw or impcrfcftly cooked, the liquor
of which swamts with germs, infusoria, and other small

aaot vsten «loi^ tbe seadiore.

Trmttt'^rU. — The tmtmeot is tmaiSa^ tbe
«• ihttt reccmiDeoded for flrtalence (sm page 150|.
ffpeciml care mart be taken lo aroid all foods likel; to
proaote femusitatiion (DietLutSo. 23i: charcoal tab-
lata (48, 49) aboaid be taken after each meal. In ob-
atuiat« cases it ia neces^ar; to confine the diet lo tbe
vary simplest arti^^es. Zwieback or granoee eaten dry
will often be digested when fluid foods give great di»-
tKM. A diet of granose and bromose (Diet List No.
25) will be ftfuod most effit-tent in relieving thia condi-
tion in a great majority of cases.

In caae« which do not yield to the above measores,
lavage, or utoniacli washing (46), must be njsoried to.
At firxt it may be neoesBary to administer lavage tivo
or three tiiweii a week, or even daily for a few days ;
but if the diet has been carefully regulated, the stomach
wanlilng may be made more aud more infrequent, until,
at the end of three or four weeks, its nsc uiay be dis-
[wiined witli altfigether, TfW luug-coutinued use of the
Htomach'tiilw in injurious.

Acidity.— Tliis eyiuptom may be due to the for-
mali'ju of either acetic or luetic acid in the stomach by
[iieiiUH of gcniiH, an has already been explained. The
H4ihfltancet( moBt liktily to give rise to acidity are bakers'
broad, milk, swocta, confectionery of all sortH, ice-
croiim, rich flmiceH, beer, wine, fluid foods, such as
Nou]>8, aud furinuceoua foods when taken with large
qUHrititiea of liquids, particularly cold fluids. In }ia-
tiuntH Kiiffi^ring from dilatation of the stomach, all

BTltFTOMATtO THEATMENT OF INDIGESTION.

103

I
I

Btarchy or saccharine foods are likely to give rise to acid-
ity by reason of fermentation.

This condition requires the same treatment as has
been recommended for flatulence and fenuentation.
Tlie habit of relieving acidity by means of soda, mag-
nesia, alkaline mineral waters, etc., is an exceedingly
injurious one, and servos to aggravate the difficulty by
lessening the activity of tho gastric juieo. The only
remedy wliith can be properly used for relieving acidity
is water. A copious draft of warm water may give re-
lief, either by producing vomiting or by diluting the ir-
ritating acids to which tlie mucous membrane of the
stomach is exposed.

Acidity from Hyperpepsia. — A form of acid-
ity not due to fermentation is occasionally encountered.
It is not due to the action of germs in the stomach, but
to the formation of an excess of gastric juice or of gas-
tric juice containing too nmeli hydrochloric acid. This
form uf acidity is likely U' be accompanied by in-
tense burning at the pit of the stomach. Gastric crises,
or attacks of severe pain in the stomach soon after eat-
ing, frequently occur in those casos. Hot liquids, acid
foods, especially fruits, and in many cases sweet foods,
increase the acidity, and are likely to give rise to pain.
Eructations of a sour or bitter liquid are frequent iu
this form of acidity. There is not usually distention of
the fitumach with gas, or flatulence ; but in some cases
gas is formed, not by fermentation, but by secretion
from the blood. In this form of acidity the pain
usually begins half an hour or an hour after eating, and
increases as long as the food remains iu tho stomach.

K3fl4

TIIR ETOMACH.

■ in »omo extreme caBL-s of this class the secretioo i
Idrochlorio iieid continues all the time, even when 1
r|t4)iiinfh coululns DO food. In th^ee instances, an ex-
I trKrouly »onr, acrid liquid is often rogargitated from the
I Btomach before eating in tlie morning.

Trout im-i't. — TliiB condition is sometimea anexcced-
I Ingly obstimite one, resisting the lueosures of treatmeul
I emiitoyed iinril botli patient and plirsiciau are thoronglilv
[ diticonriigt^d. Tlio dietary and general measnres of treat-
ment NiiggiiBted for the relief of uneasiness at the stora-
arh are apiilieitble to cases in which acidity from
euccMMive Heeretion of gastric juice is a prominent

f»yinptoiri. When these measares do not fully relievo
the condition, Hiib(?arbonate or siibnitrate of bismoth
(62) may bo taken before meals in twent>--grain doses,
and birarbonato of soda (64) either just before or soon
ftfU^r eating, or aTi hour or two later, an may be required.
Hcurtblirn. — A burning or smarting sensation,
ofttm apoken of ait " Iioartburn, " is frequently felt at
the pit of the atoniaeh or the lower end of the esophs-
gUB, BomeliineM extending upward, and often accom-
-paiiied by the rifing into the moutli of a small qnantity
very acrid, irritating, pungent, foul-smelling
\ liquid. 'Hie latest investigations on the subject seem
I to nhow tliut tliis symptom is due to the formation in
I the Btoinach of butyric or lactic acid, from the fcrmeo-
C tation of sfinio of the elements of food. The formation
mgl butyric acid is particularly favored by the presence
1 the fltoinoch of fatty substances. It is this acid
pwhich gives to old choose and ^Gvy rancid butter their
^jteculiar pungency. It is also to its presence that the
taiueating odor of vomited matters is due.

fOJtATIO TEBATMBNT (

' IND1QEBTI0N.

165

The use of cheese, an article entirely unwholesome
and utterly unfit to enter a human stomach, is very
likely to produce the sensatiou of "heartburn."

Treatm^m.t.—'When heartburn ia habitual or a con-
stant symptom after eating, lavage (4-6) ia required. Ae
a rule, however, Mimple regulation of the dietary ia suf-
ficient to effect a cure. The dii;t should be aseptic ( Diet
List No. 1), All foods difiieult of digestion (Diet List
No. 2i) and likely to give riso to fermentation (Diet
List No. 23) should be avoided. A dry dietary (Diet List
No. 2), particularly the use of such fooda aa graiiose
and zwieback (Diet List No. 25), and nut meal or nut
butter in the place of butter, should be used. Tea and
coffee and other drinks at meals shrtuld be avoided.
Employ the genera! measures recommended for ' ' Simple
Dyspepaia," for which see page 245,

Water-Brash, or Pyrosis. — This is a symp-
tom which commonly occurs whon the stomacli is
empty of food, or nearly so ; often before breakfast.
A quantity of clear fluid, either slightly acid, alkaline,
or neutral in taste, is thrown into the mouth from the
etoraach, varying in amount from less than a mouthful
to half & pint or more. It is usually supposed to be
caused by the accumulation of saliva in the stomach,
which faUs to absorb its fluid contents on account of
inactivity. The expulsion of fluid may be accompanied
by pain, or may be quite free from unpleasant sensa-
tions of any kind. It is a eymptora said to bo almost
universal among the Lapps and New Zealandcrs, and
18 also exceedingly prevalent in Scotland, where it
seems to be due to the use of insufficiently cooked
oatmeal.

■ toAsv Am AeSsidfl
I is MX iBied bvta Ae j
■ Ab ^MMk aaSv. kanp d«e to ■ s

II MS* be fvodoced bv

L, « *■—*■;; kidaer, pressirc (^

■- iBMBi, as wefl ae br emm

I DC ^mn to DM) tcmoTu

I to die eoneclion of tike

t ivq m iv i it tke ninir as that

I for '-rBcavaas tt de Ste mach ," (see

NmB

reCenvd to the ^■— — ^, wUch is boC easlj c
■■ it ja anlike aavthi^ dscL It asaallT prLcaJe s dw*
act of TcmiliD^ thoo^ nut alwrnn. ami freqneiitly ex-
Mto vithoat -voBotiag. It is derind fnaa the Greek
wovd Mil. meaning '''a ehipi,"beu^aIwaTa a protniiwmt
tympbom m a c a u Aneas. Kaiuea indkatea an irriiatloB
of the nerres of the «t«BacIi, iritic^ may be doe to an
exoeesiTe initabilitj of the nenneSf vherebj tb«?T ate
imoBiuUy excited hj the toere contact of food viih the
mnooDB membrane of the stomach ; or it mar be the
reenlt of the irritation of the nerres of the etomacb hj
acrid acids or poisonoos snbstancea prodaced by gexms
in the stomach or bj the too long retention of food ; or
it maj arise from the infection of the stomach by lat^
qnaotitiefl of microbee which the gastric juice, through
some defect in qoantitr or qaality, is Dot able to de-
stroy. There are also eome so-called nervous cases in
which naaaea ia the revolt of tlie irritation of the vomit-

BTKPTOIJATIO TKKATMENT OF INDIQESTION.

107

ing centers in the brain by poisonous subBtances circu-
lating in the blood.

Treatment. — Swallowing a few bits of ice, a few '
sips of bot water, ice over tbo stomach, ice about the
throat, fi imentationa (10, 11) over the stomach, fomen-
tatiniia to the spine, hot and cold applications to the
Bpiiie (18), faradization (65) of the spine and stnraacii,
gentle kneading of the stomach (31), suhnitrate of bis-
muth (62) in ten- to twenty-grain doses, — these are
simple measures wliicb are sometimes successful in re-
lieving vomiting. In cases of nausea iu which there is
reason to suspect offensive material in the stomach, lav-
age (46) should be employed, as the most efficient means
of relieving this condition. In cases iu which the nausea
is habitual, except in cases of pregnancy, it is often ad-
vantageous to withhold all food from the stomach for a
day or two, or even longer, nutrition being maintained
by the nutritive enema (Diet List No. 2+). Fasting is an
excellent remedy for all conditions of the stomach in
which there is excessive irritability. The general treat- I
ment should be the same as that recommended for " Un-
easiness at the Stomach" (page 155).

Vomiting. — The nature of the act having been al-
ready described, only its indications need be noted.
As a symptom of acute dyspepsia, it ia very com-
mon, but ia much less so in chronic disorders of
the digestive organs. When present, it usually indi-
cates something in the stomach wliich should be ejected,
being an effort of natm'e to defend the system from in-
jory. Sometimes the preseoee of simple mucus in ex-
cessive quantity, as in gastric catarrh, will give rise to |
vomiting. Vomiting also occurs very frequently in

168

THB (TOIUca.

coonectioa with -wfaoopiog-cotigb, chrome bronclutia,
and coneumption, being due to violetit cooj
is aliM) eomctimcB indaced, S5 is cooglung, hj tbe tick-
Hog Bcnaation prodnced in Uie throat hy a relaxed
elongated palat«. Tickling the tliroat viib the finger
or B feather will in many persons excite vomiting, espe-
cially if there is the slightest degree of nausea. Some
persons can prodnoe the act of vomiting at will.

When violent vomiting continues fur a considerable
length of time, the vomited matter consists wholly of
bile and mncns. The presence of bile leads many pep-
sone to Bitppoee that bile is the cause of the vomiting,
being an evidence of "biliousness," and having pro-
duced nausciu by its presence in the stomach. This is
UNUrtlly an errur. The bile is usually present in the
Htoniach only as the result of revevse action, indicated by
retching or long-continued vomiting.

The writer has, however, met several cases in which
dilatation or prolapse of the stomach had dragged the
pyloric orifice down to so low a point that the bil^-
wliich enters the small intestine a few inches below
the lower orifice of the stomach, was led by gravity to
flow uito the stomach, instoad of flowing in the oppo-
Hito direction, as in health. In sucii cases bile is often
found in the stomach whca the organ is othorwise
empty, rtnd if not oxpcHod by vomiting, gives rise to
constant nausea ; by nutraliziug the gastric juice, it
riously interferes with stomach digestion. Such cases,
require replacement of tlie stoniach and support of the'
orgau in position by means of the abdominal supporter

^ ■

UMATic Treatment of indiqestion.

169

The violent efforts made in vomiting sometimes ex-
. tend to the dnodemun, where the bile exists naturally,
causing it to bo thrown upward into tlie etomacli, whence
it is expelled by vomiting. The first portions of bile
vomited usually liavo a yellowish color, duo to the fact
L that the alkaline bile is nentralized by the acid contents
of the stomach. Afterward, when tlie bile becomes more
than Bufflcicnt to neutralize the acid contents and secre-
tions of the stomach, its natural greenish color appears.
Severe, protracted, and painful vomiting is a com-
on symptom o( organic disease of the stomach, us in
t cancer, nicer, dilatation, contraction, or some other
strnctnral change.

Tfeatirt{'iii. — The measures soggested for the relief
of nausea are also sometimes successful in the treatment
of vomiting. However, it is not infrequently the case
that vomiting continues in spite of tho means men-
tioned. In such cases, larnge (46), or washing of the
stomach, ia the most important measure which can bo
employed, and it almost invariably succeeds, ahlmugb
not infrequently the passage of the tube must be re-
peated several times before the stomach becomes quiet.
Surprisingly large quantities of fluid are sometimes ra-
red in cnsea of tliis sort, especially in those com-
I monly called "green vomiting." In these cases there
is regtirgitation oF bile and other fluids from the intes-
tine into tlie stomach.

Cases am occasionally encountered in which vomit-
ing seems to be purely nervous in character. These
are sometimes best relieved by the introduction of a
atnall quantity of fowl into the stomach.

Thk stomach.

There are still other caeea in which vomiting eeemB
to be purely lijsterieul in character, and which can be
controlletl by commanding the patient in a very positive
manner to cease vomiting. Tlie writer has cured a
number of cases in this way. One young woman who
had not retiiuied a single meal for more than three
years, ceased vomiting when convinced that she must
do Bo or abstain from eating. I said to this young
woman tliat I could not allow so much good food to be
wasted, and that if she insisted npon vomiting every-
thing she ate, she must cease eating. Thia she did for
a short time, but was finally glad to come to terms, and
agreed to vomit no more, which promise she kept in a
very satisfactory manner,

Trentni'-nt. — Fa.-iting, and the dietetic and other
measures recommended for "Nausea" (page 166) and
" Uneasiness at the Stomach " (page 155) should be em-
ployed in addition to the measures above snggested.
The patient should rest in a horizontal position one oeJ
two hours after eating.

Regurgitation — Rumination, or Merycism.
— Kuminatiou ia an act by which the food is returned
to the mouth from the stomach by a reversal of the act
by which food is swallowed, and without the violent
efforts attending vomiting. In some animals, as the
ox, sheep, goat, and others of the same species, all the
food is returned to the mouth in this way, being re-
chewed, lu man, regurgitation does not occur in
health, being caused by an irritable state of the mncous
membrane of the stomach, which excites contraction in
the organ, and forces the food upward. Sometimes
the act becomes more or less voluntary *, but more

SYMTTOMATIt; TEEA.TMENT OF ISDIOE8TION.

171

often it ia occasioned by a morbid condition of the
stomach, and cannot be readily controlled bj any effort
of the will.

The ease with which some persona voluntarily re-
gurgitate substances which have been swallowed is very
curi<itis. A woman who ruminated regularJy, amused
hcT friends and the public by swallowing two live gold
fish, each abnnt two and one-half inclies long, regurgi-
tating them alive twenty minutes afterward.

Regnrgitation and rumination are perlmps only dif-
ferent degrees of a morbid coniUtion. In regurgita-
tion there is usually simply a return of a small quantity
of liquid to the mouth. The patient complains of spit-
ting up or tasting Lis food for some time after eating.
In rumination proper, only the more suVul portions of
tlio fiHid are returned to the month. In most cases of
this kind the food is re-chewed and swallowed. Some
patients who ruminate profess to experience a peculiar
pleasm'e in re-chewing and regurgitating food. The
old idea that rumination ijidicates some relation to i
ruminating animals, Buch as the sheep or cow, ia of
course without any foundation. It ia a morbid condi-
tion, the exact nature of which is not well understood.

Tiraf/nent.—Tho food should consist of such sub-
stances as will bo quickly diaaolved in the stomach (Diet
List No. 7). In severe eases, a liquid diet (Diet List
No. 11) should be employed. Granose, bromose, and
kamyss (Diet List No. 25) have been found especially
helpful in extreme cases. The diet recommended for
" Simple Dyspepsia " (page 245) should be employed.

Gripes, or Colic. — This symptom, sometimea
called "belly-ache," is caused by irregular muiscular ;

172

TBK STOMICB.

contraction, or epasm, of tlie small intestine. The ex-
citing canso may be distention with gas, or the presence
of irritating matters in the TkjwcIs. It is very common
in patients subject to constipation.

Colic pains are sometimes caused by the introduc-
tion of air into the colon in the administration of the
water enema. In nsing the bulb syringe, this is quite
likely to uccnr, but it cannot take place to any ext«nt in
the use of tli« fountain ByrUigc.

Tre<if»n=nf. — Fimientation (10, 11 1, hot enema (22),
drinking one or two glasiies of hot wattT either with or
without the addition <if a few drops of peppermint es-
sence or camphor, with a dry or aseptic dietary (Diet
Lists Ni>8. 1, 'Jj constitute the treatment for this disor-
der. In cases In which starch cannot In: digi'sted, a
nitrogeuona diet (Diet List Ho. 3) should be adopted,
and all f<x»Is avoided wliieh are difficult of dige8ti<^Q and
liable to promote fennentation (Diet Lists Nos. 23, 23).
The general treatment recommended elsewhere for simple
dyspepsia or Bh)w digestion bIiouM bo employed.

Weight — Constriction ^Tightness, etc. —
A symptom very often complained of by patients
who may or may not have acidity, heartburn, water-
brash, and other local symptoms, is sometimes referred
to as "a constriction."' "a tightness," or "oppres-
sion," and is generally roferred to a point a little to
the left of the median line, just beneath the lower
border of the ribs. It indicutea a catjurhal condition
of the membrane of the atomacli. The sense of fulness
whicli it often occasions after eating is deceptive,
being quite as great in many caaos when the stomach
is empty, or when only a small quantity of solid food

BYMPTOMATIO TKEATMBST OF INDIOESTION.

173

or liquid haa been taken. Persons suffering thus lire
QBnally very despondent, and it may be this fact that
has given rise to tlio term fiypochyndria, which literally
has reference to tlio region in which the sensation de-
scribed is felt. It often iiccompanies spermatorrhea and ■
other forms of sexual weakness.

The "sinking sensation " at the stomach, of which'
many patients complain, though not identical with, is
allied to, the sensation of weight described.

The eensations of weight, constriction, tightness,
palling, and others similar, when nut the result of an
excessive meal, are due to an abnormal sensibility of
the nerves of the stomach. These sensations are most
likely to bo present in cases iu which the stomach is J
prolapsed or dilated, and are due to a strain upon thel
branches of the sympathetic nerve which enters thB,
stomach from tlie solar plexns.

Treatment. ~-T\\e same general treatment should]
be employed as is recommended for " Fneaeiness at thet
Stomach" (page 155.) The abdominal supporter is iis<J
nally required fiS).

Pain. ^ Ah a symptom of dyspepsia, pain majrl
appear in the region of the stomach, or it may be 1
referred to the spine, the chest, beneath the shoulder-l
blade or between the shoulders, or, in fact, to any parti
of tho body. The most qshuI pain is a dull aching!
after meals at the pit of the stomach, which is in- J
creased on pressure either with the palm of the hand J
or with tho tip of tho fijiger. In some cases pain, J
though not severe, is constant, being no greater after a
meal than when tho stomach is empty, and often being
apparently relieved by bland food, bat coming on agua

17*

THE ffTOUACH.

as Boon as tbe stomach is empty. This sort of pain ie
nsnally accompanied hj a pain beneatli the sboalder.
It indicates congestion of the mDCooe membrane of the
stomach, and being asaalW preceded by the sense of
weight already described, is donbtless indicatiye of
gastric catarrh, in many instances at least.

Sometimes pain felt in the stomach comes wholly
from increased sensibility of the mucous membrane.
This condition is accompanied by abnormal sensibility
elsewhere, in most cases, and conunonly occurs lo per-
sons of hysterical teniieiicies, chiefly in young ladies.
It not infrequently accompanies the condition rather
vflgnely known us "spinal irritation." I have nearly
always found tenderness at the epigastrium present in
cases in which there was marked tenderness of the
dorsal sptnc, and 1 have also noted tliat in these cases
pain is always jtresent at two important diagnostic points,
known iis Bm-kart's tender points, eitaated about two
inches on each side of the umbilicus. The tenderness
at these points is elicited by deep pressore, with the
patient lying on his back and the knees drawn up.

A constant, wearing pain, though not severe, often
becomes unbearable from its long continuance. It
gives to a person a haggard, despairing look, which is
alHo in part due to deprivation of sleep, anotlier ill con-
sequence of this variety of pain. The local pain is
often aggi'iivated by shooting pains emanating from the
pit of the stomach, and running into the limbs and
other parts of the body. Patients frequently complain
of ft pain fait "clear through the body," starting from
iho ])it of the stomach, and terminating in a tender
spot in the spine nearly opposite.

STHFTOUATIO

' ISDIiiBSTIOB.

Fain aecompanied hj vomiting of blood is iodicatiTe
of gastric nicer or of some otber serexe :
trouble. Flatolenee produces a pain pemliar to itatU. I
Neuralgia of tbe stomadi is one of the ntoM fleren'
pains an indiridaal can erperience, often coming on
sodden];;, and in many cases soon after eating, and by
its intensity not infreqaently causing fainting.

Soreness on pressnre, with nenralgic and other 1
pains, also exists in the small intestines in some cases of \
dyspepsia, the conditions being essentially the s
those present in stomach pain.

It should be remarked in this connection that the I
various pains referred to are often mistaken for other
diseases. The pain in the chest leads the patient and
his friends to believe that he has consumption ; and the
emaciation occasioned by the defective nutrition seems '
to confirm this opinion. If the patient has a slif^t <
coagh, this diagnosis is considered certain, and he ia
hurried off to Florida, California, Colorado, or some
other locality supposed to be favorable for consump-
tives. By change of air, scenery, diet, increase of ex-
ercise, etc., the patient recovers, and the locality visited
gets the credit of having cured a case of consumption,
when the lungs have been snund from the first. If the
patient stays at home, some qnack or a worthless nos-
trum is quite likely to get the credit, and every real con-
sumptive who hears of the wonderfnl care forthwith tries
the same remedy, but of course without benefit.

Such cases occur constantly, yet it must not bo sup-
posed that all pains in the cheat come from the stomach.
The same mistake is made in respect to other pains. :
In the region of the heart, it is supposed to be heart j

176

THB BTOUAOB.

disease, eapeeiall}' if there is sympathetic palpitation of
that organ 1 Pain between the shonldurs ia spinal dis-
ease. Occurring lower in the spine, it is thought to be
kidney tronble, especially if there happens to be a sedi-
ment in tht! ui'ine. Pain m the dnodenum, occurring
just beneath the lower b(*rc]or of the ribs on the right
Bide, is "liver complaint," and is accordingly treated
by a plastor or a "livor pad " 1

It is often difficult to undeceive the patient, and to
relieve him of the idea tliat he is suffering from some
terrible organic malady, — an ulcerated lung, an abscess
of the livor, incurable disease of the heart or some other
organ.

The supci-fleial character of these pains, and the
readiness with which pain is developed by pressure of
the finger upon certain tender points, which for the
most part He bt-tweeu the ribs, aloug on either side of
the sternum and the spine, and half-way between the
sternum and the spine, is sufficient evidence that they
do not arise from disease of the deep stiuctures, or the
organs which lie within the trunk. It should be re-
membered, however, that disease of the lungs, liver, or
other interna! organs may exist in connection with tliese
Buperficial pains. Pains of die character described are
generally due to irritation of the sympathetic nerve
either from the presence of acrid substances in the
stomach or from a strain upon the sympathetic nerves
produced by prolapse of the bowels or stomach, or the
constant pull upon these uen'es by a floating or wan-
dering kidney, a condition frequently associated with
prolapse of the stomach, and the dTS]>eptic symptoms

arising

from this condition.

8TMPT0MATI0 TRBATMKNT OF IHTWOEffnOM.

177

Migraine, or nervous headache, is, in tlio writer's
experience, always associated with dilatation of the
stomach, and the formation within tlie stomach of poi-
sons or poisonous suhstancea, or the strain upon tiio
sympathetic nerves caused by prolapse or dilatation of
the stomach and associated organs.

Pain may exist in the stomach, liver, bowels, or
other organs concerned iu digestion, as the result of dis-
ease of the pnemnogastric nerve — the nerve of seusation
for these as well as the other organs of the abdomen.

Tj'eatmeiti.^The treatment consists of the hot-water
or mustard fomentation (10, ID, hot trunk pack (7),
wet girdle (9), abdominal supporter (4'5), and aseptic
dietary (Diet List .No. 1) or a dietary of well-disinte-
grated foods (Diet List No. 7). In extreme cases,
a liqnid diet (Diet List No. 11), the use of granose,
bromose, and kumyzoou (Diet List No. 25), electricity
to the spine, stomach, and abdomen (65, 67, 69), and
the general trealmt'iit recommended elsewhere for ' ' Un-
easiness at the Stomach" (page 155) should be employed.

Biliousness. — What is termed " biliousness, " or
f'a bilious attack," is really aeutu gastric catarrh. From
the long retention of undigested food, the stomach be-
comes irritjitcd to snch a degree that nausea and vomit-
ing arc produced. At firnt the matters vomited" consist
of undigested food in an advanced stage of decomposi-
tion, as indicated by the foul odor and nauseous taste.
After vomiting has continued for some time, bile and
mucus are the principal matters expelled. Tlie patient
Boon feels bettor, and in a few days ia as well as ever.
In these cases the difficulty is really in the stomach,
and not in the liver, as many suppose, tliough snch

178

THE STOMACH.

attacks may be accompanied by dietarbaiice of the
functions of the livor. The irritation extends down
to the duodenum, its mucous membrano becoming eo
flwollen that the opening of the duet from the liver
is obstructed. This occasions retention of the bile,
and absoqjtion takes place, when the individual notices
a jaundiced color of the skin, a dingy appearance of
the white of the eye, etc. This is what gives to this
symptom, or group of symptoms, the term bi'ltomt/n^ss,
when it ie really gastric catarrh.

One of the most common causes of acute gastric
catarrh is "taking cold" after overeating or eating
food difficult of digestion.

Biliousness is due to the abnormal development of
poisons in tlie stomach or intestines, and the failure of
the liver to destroy these poisons or remove tfaein from
the blood. A healthy liver is able to protect the body
from an ordinary amount of poisonous substances ; but
wlien a person indulges in such gross articles of diet as
cheese, raw oysters, rich gravies, fat moats, or liabitu-
ally makes free use of meats of any sort, or paralyzes
his stomach by the nse of alcohol, tobacco, tea, or
coffee, and in cases in which the stomach retains its
food for too long a time as the result of dilatation or
prolapse from corset wearing, tlie poor liver is over-
whelmed with such a quantity of poisons that it is
unable to completely disinfect the blood brought to it
from the stomach and intestine ; consequently the whole
system is invaded by them, and a condition of general
systemic poisoning, or what Professor Bouchard terms
*' autointoxication," or self-poisoning, is produced.
It will readily be seen that biliousness is not due to

STVPTOltATIC TBS1.TMBIIT OT IMDiaBSTION.

179

torpidity of the liver, but to abuse of the liver. The
liver does its work as well as it can under the circmn-
stances. The thick brown coat upon the tongue and
the bad tiiate in the mouth experienced by bilious
peraoDB are indicative of an unclean state of the whole
alimentary canal and the genera! poisoning of the entire
body. It is not simply the patient's tongue which
tastes bad, but it is Le himself. The relief obtained
by the use of mercury and other so-called cholagogues
is not duo to the stimulation of the liver, as is generally
aup])08ed, but rather to the disinfection of the alimen-
tary canal through the carrying off of a quantity of germs
and decaying substances.

The treatment of this condition should be the Kante
as is elsewhere recommended for "Bilious Dyspepsia"
(see page 251).

Appearance of the Tongue. — Wliile the im-
portance of tile condition of the tongue as a symptom
of dyspepsia is such as to make its mention necessary,
it should bo borne in mind that its indications have
more distinct reference to the system in general than
to the stomach in particular. A clean tongue, of
natural color, appearance, and moisture, ia a pretty
sure indication of health. Unnatural redness of the
tongue, most commonly at the tip and edges, some-
limes with a strawberry appearance, indicates an irrita-
ble state of the stomach. It is usually accompanied
by soreness at the pit of the stomach, little appetite,
and great thirst.

A yellowish or creamy coating on the tonguo in-
dicates an inactive state of the stomach and intestines,
giving rise to a foul condition of the organs. If

180 THE STOHACH.

small portion of the sluny jellow or brownish material
covering the tongne is planted upon the cut Biirtace of
a boiled potato, and exposed in a moist room for a few
days, the potato will be found covered with a thick
growth of germs closely resembling that upon the
tongne, demoustrating that the coat upon the tongue is
really a growth of fungi eirailar to a patch of mold
upon the wall. or mildew upon a garment. When this
condition exists, not only the tongne, but the stomach,
is also infested with these miachief-raaldng microbes.
The bad taste experienced in connection with a foul
tongue is due to the production of poisons by the
germs. The headache, uHusea, loss of appetite, and
other symptoms which often accompany a coated
tongue, and the bad. taste in the mouth, are due to the
absorption of these poisons from the stomach, where
they are often produced in enormous quantities. Plate
V shows the appearance of germs from the tongue and
the stomach as seen growing upon the cut surface of
a sterili/ed potato, and also the appearance of these
germs as seen under the microscope.

A white coat on the tongue indicates a feverish con-
dition. This often appears in connection with unnatu-
ral redness at the edges and tip, indicating kritation.

A broad, pale, flabby tongue indicates a weakened,
debilitated condition of the digestion and of tlie whole
system. A tongue of this sort usually exhibits inden-
tations on its margin, formed by the teeth, owing to its
flabby state, usually present in hypopepsia.

A brown coat upon tbo tongoe is very common in
acute dyspepsia. It is often accompanied by a bad
taste in the mouth, with unnatural dryness. Sometimes

TREATMENT OF INDIGESTION.

181

this iB doe to slooping with the month open, by which
the secretions and epitlielinm becomo dried to an un-
natural extent.

Sometimes the tongue ia coated in the middle, the
edges being smooth and clean. Tltis is dae to the fact
that the epithelium Jias become softened on the smooth
portions, and has been rubbed off by the friction of the
teeth. Clean spots are also due to lost epithelium, in
many cases.

Transverse fissures of the tongue indicate a diseased
state of the mucous membrane of the stomach, usq-
ally due to acid dyspepsia,

Treatmenl. — A yellow or brown coat upon the tongae
indicates an infected condition of the stomaeli, which
requires the treatment recommended for '* Bilious Dys-
pepsia" (page 251). A broad or pale, flabby tongue
indicates hypopepsia, and requires the treatment recom-
mended for this condition (see page 260). In cases
accompanied by rise of tempL-rature, the patient's diet
should be carefully restricted to such foods as are
suitable in fever (Diet List No. 12). Fine charcoal
(4^7, 48) should ho freely used in cases in which the
tongue is unusually foul, and the patient shnnid be
made to drink water freely. The amount taken in
twenty-four hours should usually be from three to six
pints More is often advantageous.

Aphthae. — In cases of acidity of the stomach, oc-
casioning uritability of tlie organ, little pimples often
appear on the sides and under part of the tongue, and
just within the corners of the mouth. After a short
time, small white patches of lymph may be seen, which
frequently leave very troahlesome little ulcers when

182

TELE STCIUACB

they disappear. These very annoying ulcers are poai-
tive evidence of stomach disorder, though the patient
will often assert that he has no difficulty with his food,
and never experiences any pain or inconvenience con-
nected with the stomach.

Aphtbffi are probably most often present in cases of
hyperpepsia, or excessive secretion of the gastric juice ;
but the writer has also found them present in hypo-
pepaia.

Treatment.^- The mouth should be thoroughly
cleansed after each meal ; it should be rinsed every
hour witli a saturated solution of boric acid or chlorate
of potash. The ulcers may be touched with a solution
— forty grains totlie ounce — of nitrate of silver, after
being carefully dried. Treatment for either hyperpep-
sia or hypopepsia should be employed, according to the
indications of other symptoms.

"Throat-Ail." — Congestion of the pharynx, with
a granular condition of the mucous membrane, relaxation
and elongation of the uvula, accompanied by a sense of
constriction, tightness, dryness, tickling, and other
symptoms, are not infrequent indications of stomach
disorder. The patient is often much troubled with a
tenacious mucus which he finds difficulty in dislodging.
Sometimes the throat trouble amounts to real difficulty
in swallowing.

What is known aa "clergyman's sore throat" is
usually associated with disorders of digestion.

Treatment — Fomentations (10, 11) applied to the
throat at night, and followed by a cold compress, well
covered, to be worn dnring the night, and a cold sponge
bath (1) with vigorous rubbing in the morning, are ex-

flTBIPTOMATIO TRBATMEST OF IHDIOE9TI05.

cellent remedies for LoarsenesB. Gargling hot water
in tbo throat three or four tiines a day is also useful.
The vaporizer (59, 60) sliould be used five or six times
a day, five to ten mimitea each time. It may be used
to advantage even more frequently, if convenient. The
course of tonic treatment and the general measuree
indicated for slow digestion should be employed.

Sour Taste in the Muuth. — This symptora,
not a very infrequent one, is due to an acid condition
of the saliva, which not only renders it of little use as a
digestive fluid, but also rnins the teeth, by destroying
the enamel.

In anomalous cases the saliva has a swci^isli taste.

In inactive conditions of the liver, it is likely to be
bitter, so that the jtatient complains constantly of a bit-
ter taste m the month. Viscidity of the saliva, accom-
panied by an unpleasant sense of heat in the mouth in
the morning, is a common indication of derangement
of digestion.

In the careful examination of the saliva in a large
number of cases, I have found acidity present much
more often than I had formerly suspected. A careful
examination of the condition of the digestive organs
must hence include an investigation of the condition of
the saliva as regards its chemical reaction and its digest-
ive activity.

Ti'eatment, — Rinse tho mouth with a solution of car-
bonate of soda (©i') three or four times daily ; cleanse
the mouth tlioroughly before and after each meal with an
antiseptic dentifrice (57), or rinse the mouth with cin-
namon water (58), cleansing by ordinary means. The
diet and other treatment should be such as is recom-

THE STOMACH.

nionded for "Simple Dyspepsia '" with fermentation (see
page 245).

Constipation, — Though often an accompaniment
of dyspepsia, this condition is not a constant one in
that disease. There seems to be a quite general error
on this point, since many patients confound the use of
tiie term htdigestnm- with constipation. I Iiave often
been told by patients, in answer to an iuquii-y respect-
ing the state of the bowels, that their "digestion " was '
very regular, or very irregular, as the state of the
bowels happened to be. A person may have very poor
stomach digestion without any marked disturbance of
the bowels; yet constipation, or costivenoss, — -some
make a distinction between the two, — is very rarely
present without disorder of some sort in the digestive
appai'titus.

As a rule, it may be expected that any disturbance-
in the function of those digestive organs which lie
below the stomach ai'e secondary to disease of the
stomach. Intestinal catarrh follows gastric catarrh ;
cirrhosis of the liver, jaundice, gall-stones, and otlier
hepatic affections are also consequences o£ chronic
gastric or gastro-inte^tinal catarrh. Biliousness also
begins in the stomach, as has been shown. Cancer
of the liver is nearly always secondary to disease of
the stomach.

In constipation there may be either excessive hard-
ness of the fecal matters through too long retention,
and consequently too great absorption of the fluid por-
tion, or there may be lose of nerve sensibility at the
lower, or an^, orifice of the intestinal canal.

BYHPTOUATIO TBEATHENT OF INDIGESTION,

1S5

Tj'eatinent. — For the treatment nf lliiB condition,
see page 279.

Diarrhea. — This also is as marked a Bjmptom of
dyspeptic conditions as the preceding, tliongh less
frequent. Whether constipation or looseness is pres-
ent depends on the particular form of indigestion.
When the most prominent difficulty is slow digestion,
constipation ia usually present. In hilions dyspepsia, the
decomposition of the food gives rise to such a degree
of irritation that diarrhea is induced. Diarrhea iu
these cases is doubtless the result of the effect of
poisonous substances generated by the germs develop-
ing in the alimentary canal, and which the digestive
fluids have failed to destroy.

Diarrhea is also present in cases in which there is
so great irritability of the mucous membrane that the
food is hastened along without complete digestion.
Not infrequently tlio two conditions constipation and
diarrhea, alternate, each being occasioned by the other,
the vital forces being too weak to maintain a healthy
medimn of activity. Hardened fecal matters are
retained until they become a soui-ce of irritation, then
diarrhea ensues until tlie bowels have been emptied, in
part at least, this excessive activity being followed by a
return of the constipation.

Treatment. — The treatment of this symptom will
vary according to the conditions which gave rise to it.
If other symptoms indicate foul or bilious dyspepsia,
then the treatment elsewhere recommended for this con-
dition should be employed, together with a large hot
enema administered daily. Charcoal (4-7, 4'8) or

THB BTOHACa.

antiseptic charcoal tablets (4-9) should be habitnally
used.

When diarrhea is due to excessive irritability of the
mucous membrane of the stomach, indicated by a red,
sensitive tougue and other eymptoms of irritation of tlie
alimentary canal, liquid food (Diet List No. 1 1) or food
which will readily dissolve in the stomach (Diet List No.
7) should be used. A diet of kumyzoon (Diet List No.
2.>}, kumyss, or buttermilk is sometimes required. An
enema taken after each movement to cleanse the bowels,
fomentations (10), a wet girdle (9), and in cases of
prolapse of the bowels, with dragging sensation across
the abdomen, the abdominal supporter, are very help-
ful measures used in connection with ttiose means
which are indicated by other symptoms of indigestion.
In old and very feeble patients, " Nutritive Treatment "
(page 331), and in stronger subjects, "Tonic Treat-
ment " (page 333) should be employed.

Long, patient, and persevering treatment ia re-
quired in these cases. Sometimes in chronic diarrhea,
the "Rest-Cure" (see page 359) for two or three
weeks, and a diet consisting chiefly of kumyss, kumy-
zoon, or buttermilk, and eggs is necessary to give the
patient a good start in the direction of health. The
daily hot enema (22) and " General Tonic Treatment "
(page 333) are required in these cases.

Backache. — This symptom is so common in dys-
pepsia that it requires separate consideration. A
chronic ache in the lower part of the back is due to an
irritation of the lumbar ganglia of the sympathetic nerve
(page 193). Fain or soreness between the shoulders is
dae to irritation of the solar plexus. The sjonptoms

STMFTOMATIO TEEATMEHT OF IND1GB8TI0N.

1S7

arise most frequently from prolapse and dragging of the
stomach and bowels. Prolapse of one or both kidneys
or of the liver or spleen ia also frequently present in
these coses. Examination of the abdomen shows a
Bagging or abnormal protrusion of the abdomen at its
lower portion. In these cases tenderness is found
; deep pressure at points two inches on
either side of the ombilicns. Constipation ia usually

Treatment. — The following measures will be found
the most eSective : "General Tonic Treatment " (page
333), fomentations (10, 11) to the spine, hot and cold to
the spine (18), hot and cold trunk park (8), applications
of electricity to the spine (65, 67, 69), Swedish move-
ments (41). Proper measures for the relief of consti-
pation should be employed (see page 379).

The Stools. — Quite too little attention is paid to
the character of the bowel discharges by physicians as
well as by patients. In all cases of dyspepsia, they
should be carefully and frequently examined. The
stools should be well-formed and of moderate consist-
ency. Kagged, unformed stools indicate some degree
of irritability of the digestive tract. " Watery stools
show deficient absorption, or too profuse secretion from
the mucous membrane. Slimy discharges indicate a
catarrhal condition. Small, pellet-like masses are
indicative of constipation due to deranged function
of the colon. If the discharges are unnaturally light
in color, too little bile is present. An unnaturally dark
color, with very offensive odor, often accompanies foul
dyspepsia. The appearance of portions of undigested
food indicates great inactivity of the digestive organs.

188

THE BTOMAOH.

A microscopic examination is often extremely useful,
as by tliis means it can ho ascertained, in majiy cases,
what particular element of tfie food may not be well
digested. For example, if fat globoles are found in
great abwidance, the indigestion of fat or oleaginous
substances is indicated ; if portions of undigested meat
are discovered, difficulty in digesting animal food will
be ■ understood.

Examination of the fecal (liscbargea also affords the
only reliable evidence of worms, as by this means eggs,
if not the worms themselves, may certainly be found if
they are present. Examination for the eggs of piiror
sites requires tlie nse of the microscope in the hands of
an expert.

Tread/iffuf.—The treatment required for abnormal
conditions of the fecal matters varies according to the
indicatiouH, Dark, offensive fecal matters indicate a
foul condition of the alimentary canal, requiring an
aseptic dietary (Diet List No. 1), charcoal or antiseptic
charcoal tablets (47, 48, 49), and the general measures
recommended for bilious dyspepsia. Bilious or septic
indigestion (page 251), with alight discharges, indicates
a catarrhal condition of the bowels. Tlie presence of
mucus in excessive quantity indicates a catarrhal condi-
tion of the intestines. If the mucus is discharged first,
a catarrhal condition of the lower portion of the rectum
exists. If the mucus follows the feca! discharge, the
catarrhal condition is located higher up in the bowel.
If the mucus is mixed throughout the fecal mass, it is
probable that a considerable portion of the colon is af-
fected. This condition requires an aseptic dietary (Diet
List No. 1), especially the disuse of all forms of flesh

SYHFTOHATIO TREATUENT (

1S9

food, the use of charcoal (47, 4% 49), a large hot
enema daily, to thoroughly cleanse the bowels, to be j
followed by an astringent enema consisting of a draiQ'l
of tannin to a quart of water, the last to be retained 1
for half an hour, if possible. Masses of undigested |
food indicate the need of a dietary consisting of well- '
disintegrated food substances (Diet List No. 7).

For a liquid dietary (Diet List No. 11), in extrems'l
cases, a diet of kumyzoon (Diet List No, 35), kumysBj ■
or buttermilk is rec|uired.

The Urine.— Examination of the urine is im-
portant, though littlo need be said on thia point, as a
reliable examination can be made only by a competent
physician. A white, piuk, reddish, or brick-dust sedi-
ment ia very common in dyspepsia, together with other
deposits. These are most often found after an unusu-
ally severe attack of indigestion. Tho fact that deposits
ui the urine are frequent in this disease, is nietitionvd
more particularly hocauso those
who are ignorant on tho subject
are often lud, by tho advice of
quacks or otherwise, to take this
as evidence of disease of the kid- ^'IXW^ j-<)L S
ueys, of which it is not a posi- LP\\^^i^^

live indication. These deposits

the liver to oxidize, or reduce to urea, the great quantity "j
of imperfectly prepared matter tlu-own into tho blood, .
Tliey are particularly liable to be present in persons I
who use considerable meat. ( See Fig. 18. )

Tr&itiiumt. — A white, pinkish, reddish, or brick-'
dust sediment indicates the necessity for an aseptic diet |

THX STOMACH.

(Diet List No, 1), and eapeciallj the avoidiinco of all
_ articlea hard to digest and likely to undergo fermenta-
tion (Diet Lists Nob. 22, 23), and the disuse of meat.

Tliis condition often precedes Bright's disease, and
sboold receive careful attention. The patient should
drink from three to six pints of water daily, and should
exercise out of doors two or three hours daily, the exer-
cise being as vigorous as is consistent with the strength
of the patient. A hot bath of some kind once or twice
a week, and ' ' General Tonic Treatment ' ' (see page -333)
ehould be employed. Fomentations (II) over the liver
daily, and the wet girdle (9) are also measures of value.

Dryness of the Skin. — A peculiar dry, rough
condition of the skin is very common in dyspepsia,
though not jwculiar to the disease. In those cases, the
natural secretion of tlie skin is greatly diminished. The
patient will frequently complain that he never sweats.

In some forms of dysjiiepsia, the opposite condi-
tion is present, the skin being tawny, and having a
greasy feeling. Occiiaionally it is unusually clear,
pliable, and sensitive, sometimes being almost trans-
parent. These cases usually occur among nervoue
dyspeptics.

Treatment. — "General Tonic Treatment" and ft
daily oil rub (27) are indicated for the relief of this
condition.

Skin Eruptions.— The use of particular articles
of ftKid will in certain individuals give rise to various
skin eruptions snon after eatiug, the eruption being
accompanied by marked evidences of indigestion-
Eczema, ncnc, and other skin diseases are chiefly
dependent upon disordered digestion. All the glandu-

STKFTOIIATIO TKKATHBIfT OF niDIQESTION.

181

lar strnctureB of the bod^ are controlled by the Bympa-
thetic nervona ayfitem. la diseases of the stomach,
this nerve ia certain to be more or loss affected, and
hence disturbance arises in the glmida aa well as in tiie
other BtriictnrcB under the control of the sympathetic
nerves. Indigestion in in this way the principal cause
of acne, or pimples of the face.

Trmtmeiit. — Relief of the digestive disorder by
'•General Tonic Treatment" (see page 333), ahonld
first be sought. Zinc ointment, obtainable from any
drng-etore, may be applied to the ernptions. For chronic
coses of eczema, with a thickening of the skin, the daily
application of hot water by moist cloths (10) or a htit pour
(19) is a proper measure to be employed. Acne some-
times requires the use of a hot solution of corrosive
sublimate, one part of tlie sublimate to two hundred of
water, after a thorough cleansing of the parts with soap
and water. Care should be taken not to get the solution
into the eyes or mouth, as it is very poisouous. Use
daily ffir five minutes.

Colli Feet, etc. — To cure cold feet, do not heat
them at the fire nor parboil them In hot water ; this
only relaxes and weakens the circulation. A better
plan is this : Just before going to bed, place the feet in
a cold bath, with the water about one fourth of an inch
deep. In a few minutes, dry and rub warm ivith a
coarse cloth or with the hand. The alternate hot and
cold foot bath may bo used with still greater effective-
ness. At night, if the feet cannot otherwise be kept
warm, hot jugs or foot-stones may be employed ; but it
is far better to bo independent of such artificial sub-
stitutes for vital heat by wearing warm bed socks.

193 THK BTOMACH,

'VTheii the feet or hands are too liot, they may be
oooled by employiug cold instead of heat. Ice-water
may be employed when necessary, and will be found a
most excellent means of relieving the unpleasant burn-
ing of the feet from which many people, especially
older persons, often softer much.

Coldness of the extreraities in dyspeptics is dne to
an irritated condition of the abdominal sympathetic
nerve, whereby the blood-vessels are caused to con-
tract, 80 that an insufficient amount of blood is circu-
lated through the extremities. Patients suffering in
this way often complain of a dragging sensation aci-osa
the lower abdomen, or an aching in the back, espe-
cially when obliged to be much upon the feet. There
is also a disposition to elevate the feet in sitting, and
a symptom commonly known as "fidgets" is often
present. These symptoms indit:ate the necessity for
relief of the irritation of the abdominal sympathetic,
and also for the support of the abdominal organs, the
downward displacement of which is a cause of the
UTitation. The principal measures required are fomen-
tations to the abdomen daily, the wet girdle (9), and
"General Tonic Treatment" (see page 333). The ab-
dominal sujiporter (45 1 should be worn constantly when
the patient is exercising in an upright position. The
application of electricity (65, 66, 67) and Swedish
movements (40) are also very useful measures in these
cases.

Headache. ^ — Various forms of headache are
among the most common symptoms of dyspepsia. In
different cases, different parts of the head are affected,
and in the same person at different times. The whole

8TMPT0MATIC TREATMEKT OF INDIGESTION.

head may be affected, feeling, aa the patient sometimes
says, "as though it would burst." Again, the pain
may be confined to the temples, or to the biick or front
of the head, to the top of the head, to the region of the
ears, to the eyeballs, to tbo upper part of the neck, or
it may extend down between the shoulders. In many
there is also tenderness of the part affected.

When headache occurs during digestion, or soon
after eating, it is usually of a dull, heavy character,
often located in the front part of the head, and is
accompanied by more or less confusion of thought, cold
feet, and sometimes dunness of vision. This form of
headache is often accompanied by a sense of weight at
the pit of the stomach.

The beadatihe which comes on the next day or sev-
eral hours after taking an indigestible meal, is of a
more severe character. It is commonly accompanied
by pain and tenderness just below the ribs on the right
side, in tbe region of the duodenum, which is probably
the part chiefly affected.

Migraine, or Nervous Headache. — This af-
fection, long treated as a nervous disease, has been
clearly proved to be a purely symptomatic malady, re-
sulting from irritation of the sympathetic nerve as the
result of tho action of poisons formed in the stomach,
A careful stady of a large number of these cases has
convinced the writer that nervous headache occurs only
in persons suffering from dilatation or prolapse of the
stomach. After having made a careful examination of
a large number of cases of this disease, numbering
more than one hundred in all, I am able to say that I
have failed to find a single case in which there was not

1(*4

THB STOMACH.

evidence of great irritation of the abdominal eyrapa-
thetic nerve, aa shown by extreme sensitiveness at the
tender points first pointed out by Burkart, in 1882,
Tliese points lie about two inclies on each side of the
umbilicus, at the posterior surface of the abdominal
cavity. An indication of chronic poisoning which is al-
most invariably to be found in these cases is the fool
tongue and malodorous breath presented by the patient,
and which afford the most indubitable evidence of a
septic condition of the alimentary canal. A peculiar
bitter, or what is frequently described by the patient as
a "nasty," taste in the mouth nearly always accompa-
nies this disease. The disagreeable, and often fetid,
odor of the breath is evidently derived from the forma-
tion of Bulphuretic compounds, the extremely toxic
character of which is well known. Pepper mentions
coses in which jewelry worn by the patient was always
tarnished during an attack of this disease.

Intellectual overwork or worry is an exciting cause
of the disease only through the fact that by reflex
action downward it increases the sensitiro condition of
the abdominal sympathetic, and at the same time re-
tards the digestion, and eo favors both the production
of toxins, which are the direct cause of the disease, and
the susceptibility of the sympathetic nerve to the action
of these poisonous substances.

The frequent occurrence of attacks of migraine at
the menstrual period in women is occasioned simply by
the increased sensitiveness of the nervous system at.
that time. It is a well-established fact that both mental
and nervous disturbances are much more likely to occur
in women at the menstrual period than at other times.

BTMPTOMATIO TREATMENT OF mDIOXSTIOIT.

195

Those who have made a careful study of this dis-
ease will at once recall manj circumstances which arc
confirmatory of these views. Many have doubtless ob-
served in certain cases a peculiarity of the disease men-
tioned by Niemeyer, who remarks as follows : " In
some cases, a severe attat^k, particularly if it ends with
sick stomach, results in a certain immunity to relapses."
Vomiting is, of course, in some degree equivalent to a
lavage, and so affords the patient temporary exemption
from suffering. The fact that great benefit may be de-
rived from the use of saline laxatives in many cases,
the disease being frequently aborted by the early nse of
an active cathartic, ia another confirmatory evidence.
It will also be remembered that food of any kind, no
matter how simple or digestible, frequently aggravates
the disease, although there are occasional cases, as
mentioned by Brinton, in which the taking of a hearty
meal seems to terminate an attack, probably by excit-
ing stomachic and peristaltic activity. Niemeyer re-
marks as follows with reference to the treatment of this
disease : —

"In most cases we can do nothing but attend to
existing disturbances of the general health and of the
digestion, and the chances of benefit from treatment
are much greater when we can discover any such dis-
turbances. During the attack we should spare the pa-
tient from the use of any remedies, and let him take
nothing but water."

Viewed from this standpoint, migraine is no longer
a complex or mysterious nervous malady, but simply a
state of systemic poisoning, the origin of which
is decomposition of food products in a dilated or

THE STOUACB.

prolapsed stouiach which, through muacnlar weakness,
ia unable to rid itself of its contents with enfficient
promptness to prevent eeptic and pntrefjing processes.
Although tliese causes m&y be constantly in operation,
they do not nsuallj produce pronounced symptoms of
poisoning except at intervals, the kiJneys ordinarily elim-
inating the poisonous substances with sufficient rapidity
to prevent those "norve storms" to which the term
migraine, or megrim, has been attached, except when
the nervons system is by excessive nervous or mental
activity, or by the functional disturbance of menstrua-
tion, rendered unusually susceptible.

The remedy for this malady is to bo sought, then,
not in the discovery of some new drug which shall tern-,
porarily paralyze the nervous sensibility, reduce the i
blood pressure or raise it, as may be required in the
individual case, but in the remo^■al of the real cause of
the disease. The writer believes tliat every case of
migraine is capable of being radically cured.

Treatment. — The treatment required in these cs
consists of two classes of measures : —

1. Those that are palliative, or asefnl daring aa I
attack.

2. Those that are curative, to be used in the inter-
vals.

The most efficient of all paUiaiive means ia lavage, or
washing out of the stomach. By employing lavage (46)
at the very beginning of the attack, it may often be cut
short, and by adopting this measure still earlier, aa on
the appearance of the first premonitory symptoms, it is
found possible in many cases to prevent tlie attack al-
together. Many times the stomach-tube brings ap a

MATTQ TREATMENT OF INDI0K8TI0N.

197

great quantity of ill-Bnielling, andigeeted, and decompos-
uig food. In other cases, no food, bat a small quantity
of clear but very bitter and acrid fluid, Ja obtained.
When there is very marked dilatation, it is some-
times necessary to repeat the lavage a number of times
before the stomach ia completely cleared of its fetid
contents. Not infrequently there is bi!o present. It
should not be forgotten that the bowels as well as the
stomach may contain a conaidorable amount of decom-
posing matter ; hence a large hot enema (22) should be
administered as a means of cleansing the lower portion of
the alimentary canal. This should be done whether the
bowels are known to bo constipated or not, Tlie enema
serves a useful purpose, not only in washing out the bow-
els, but in supplying fluid to the body, by which the kid-
neys are aided in eliminating the irritating poisonous
substances with which the blood ia charged.

Hot and cold sponging of the spine (18), fomenta-
tions to the heatl when the face shows pallor, and also to
the stomach, heat to the extremities if cold, and appli-
cations of galvanic and faradic electricity (65, 70), are
needed. It must bo admitted, however, that no reme-
dies are of very great value when an attack is once fairly
started, although faithful Bse of the measures snggeated
will certainly serve to cut short the attack. The use
of antipyrin, migranin, antifebrin, and other allied
drugs is to bo deprecated, for the reason that these
drugs, though Bometimcs temporarily palliative, soon
lose their effect, requiring an increase of dose at each
successive attack, until the injurious results of the drug
may become a more serious matter than the disease
itself.

IPS

THE nOHACH.

The patient should not est daring an attack, or at
least not tmtil after the first twenty-four boore. There
is, however, an occasional exception to this mle,
which eating after the omission of a single meal seems '
to aid in bringing the attack to a termination by nn-
loading the contents of the stomach into the intestine,
and thus provoking movement of the bowels. The
first food taken should consist of some simple cereal or
fruit preparation. All forms of flesh foods and animal
extracts, and also milk, should be avoided. Tea and
coffee, which are popular remedies for sick-headache,
are highly detrimental ; for although they may some-
times mitigate the symptoms during an attack, they
prepare the way for a speedy recurrence of another.
Granola, granose, zwieback, gluten, and water breads I
of various kinds ; grapes, peaches, in fact, frnita of all
kinds ; and such green vegetables as peas, asparagus,
and string beans, are wholesome and suitable, but for
these cases should be cooked without milk or cream.
Kuts, if well chewed, — preferably, however, taken in
the form of nut meal ( Diet List No. 25 ) , — afford the
most suitable form of fat. Milk is allowable only in
the form of buttermilk, kumyss, knmyzoon ( Diet List
No. 25), or cottage cheese. It should be carefully
sterilized.

The curative treatment of migraine consists of a care- j
ful adhei'ence to an aseptic dietary ( Diet List No. 1 ),
special preference being given to the articles mentioned. ■
Everything possible should bo done to baild up the
patient's general health. For this purpose the cool
morning sponge bath (1), followed by vigorous rub-
bing with a towel or fleah-brush, and the wearing of

8TMPTOMATI0 TKEATUENT t

INDlaBSTION.

199

the moist al>doiimia1 bandage (9) during tlie night, are
especially lielpfnl. Outdoor exercise should be taken
daily to the extent of producing gentle perspiration.
Bicycle riding is especially helpful, also boating and
boreeback riding. Patients who soffer from dilatation
and prolapse of the stomach, however, should take
care to eapport the prolapsed viscera by a proper
abdominal supporter. For this purpose the author has
devieed an instrument called the Natural Abdominal
Supporter (45) which elevates tlio viscera in a manner*
exactly similar to that in which persons often support
themselves with their hands when they have au un-
pleasant dragging seusatiun in the lower abdomen.
Tendei-ncBs of the abdominal sympathetic may be
relieved bj the daily application of the hot water-bag
for an hour or two, or a fomentation (10). Special
pains should be taken to masticate the food very
thoroughly ; and in cases of extreme dilatation of
the stomach, the almost exclusive use of dry food
(Diet List No. 2) and well-disintegrated foods (Diet
List No, 7 ) is required, for a few weeks at least.

Lastly may be mentioned tlie use of an intestinal
antiseptic as a means of preventing the development of
germs and the fiirmation of the poisons which are the
real cause of this disease. One of the very best of
these is vegetable charcoal, preferably charcoal made
from cereals (^T, 48). The addition of a small pro-
portion of sulphur increases the efficiency of the
charcoaL The writer has for many years employed a
mixture of this sort, which is manufactured by the
Modem Medicine Company, Battle Creek, Mich.
(tJ. S. A.), and put up in the convenient form of very

200

TBK STOUACH.

palatable tablets (49). Two or three of these taken
after each meal aid the stomach in preventing the
action of germs, and at the eaioe time so act upon the
bowels as to prevent constipation. I know of no
remedy so valuable in the treatment of this class of
cases, and, in fact, all cases arising from septic or foul
conditions of the stomach and bowels.

Regularity of tlie bowels should be established by
the use of coarse food like granose (Diet List No. 25)
and other whole-grain preparations, and by the use of
the gradoatod enema, and other mcasorea suggested
elsewhere in this work ( ace page 279). Lavage should
bo employed once or twice a week in cases of extreme
dilatation of the stomach, or when fermentation or
considerable quantities of mucus are found present by
an examination of the etnmach fluid. The charcoal i
tablets (49) and lavage should be employed until the-j
tongue becomes clean.

Swedish movements (40), massage of the stomach
and abdomen (29, 31), daily replacement of the ab-
dominal viscera (32, 33), with general massage (36),
are measures of great value in cases of migraine.

Nervous Apoplexy. — This is another condition
dependent upon a disturbance of the abdominal sympa-
thetic, the symptoms of which so closely resemble
those of apoplexy that the person suffering from it
sometimes lives in almost constant dread of death from
paralysis as a result of cerebral apoplexy. The sub-
jects of nervous apoplexy complain more or less
habitually of giddiness, esjiecially after eating, double i
vision, scintillations before the eyes, sudden loss ofl
vision, sudden change of color in surrounding objectB, I

8V1JPTOMATIO TREATMENT OF INDIOEBTION.

everything appearing green, blue, or red, as the
case may be, and occasionally sndden I088 of con-
HCiouaneBB. The writer has had several caaea under hi«^
care in which these symptoms were very pronounced,
the patients often being brought in from the porches or
corridors, where snddenly, in the midet of a conversa-
tion, they had fallen to the floor insensible. Attacks
of nervous ajxtplexy are frequently induced by fright
or some sudden, strong emotion, or even by a lond
sound.

TrcatTneni. — In the treatment of these cases I
have BOraetimea seen tlie most remarkable results fol-
low the application of the abdominal supporter (Fig,
40), whereby the strained and irritated aympathetic
nerves, which are always extremely sensitive in these
cases, were afforded relief by the support of the pro-
lapiscd stomach, bowels, or other viscera. The moist
abdominal bandage worn at night, fomentations (10) to
the epino in the morning, followed by a cool sponge
bath (1), massage (31, 36), Swedish movementa (41),
and, if possible, the application of galvanic electricity
to the spine and abdomen (69), are the most efficient
measures of treatment.

The diet should be strictly aseptic (Diet List No, 1),
and should in all particulars be the same as that recom-
mended for nervous headache. When the stomach
is considerably dilated, lavage should be employed
once or twice a week, until the tongue, which is
always coaled, becomes clean. The bowels should
be thoroughly and regularly evacuated. Constipation
shonld be combated by the measures elsewhere recom-
mended in this work. Antiseptic charcoal tablets (49),

201 I

the I

con- ^^gj
n his^^^^l
need, ^^^^1

THB STOUAOH.

as recomnicnded for migraine, should also be need in
this disease, two or three to be takeu after each meal.
In both raigraijie and nervous apoplexy, it is eometimea
necessary to use some intestinal antiseptic habitually,
on accoant of the inability of the gastric juice to
thoroughly disinfect and preserve the contents of the
stomach during digestion.

For the immediate relief of an attack of nervous
apoplexy, employ the following measures : Put the
patient to bed in a quiet room, excluding the light and
all Bonrces of excitement. Apply fomentations (10, llj
over the stomach and abdomen ; administer an enema
(22) if the bowels are constipated ; apply a wet girdle
(9), and make hot or cold applications to tlio head
when indicated. If the head is cold and the face pale,
hot applications should be made ; if the head is hot,
hut or alternate hot and cold sponging of the spine (18),
with cold applications to the head.

Disturbance of the Circulation. — Varions
distm'bances of the circulation are common in dya-
jx'paia. Coldness of the hands and feet, or the op-
[Hieite condition, especially at night, accompanied by
an aggravated burning sousation ; unnatural heat in
the head, often accompanied by fulness of the veins
of the forehead and neck, sh(fwing intense congestion ;
palpitation of the heart, especially occasioned by excite-
ment of any kind, and sometimes coming on suddenly
without apparent cause; intermittent action of the heart,
with sudden sensations as of stopping, causing the pa-
tient to apprehend impending death ; tlirobhing of
the arteries in various parts of the body, this being
especially noticeable in irritable conditions of the Btom-

ach, which are often accompsinied by strong pulsation
of the aorta, felt at the pit of the stomach or lower
in the abdomun: eudduu flushing of tlie face, with or
without any slight mental e xci tome at, — these are the
most common Bjmptoma of tliia condition, some of
which often occasion no little uneasiness on tlie part
of the patient by exciting fears of organic disoaso of
the heart, aneurism, or some other serious malady,
which ha thinks may end his life at any moment.

Treatnumt. — " General Tonic Treatment "' (seepage
333), beginning with very gentle measures and pro-
gressing gradually, is one of the most effective means
for relief of disturbances of the circulation. For tem-
porary relief, hot or hot and cold applications may be
made to the feet and legs, and prolonged cold appli-
cations to the parts which are esoesaively hot. Cold
should be applied over the heart in caat-a of palpita-
tion, and such measures employed as have been else
where recommended for relief of reflex symptoms due
to an irritable condition of tlie abdominal sympathetic,
as indicated by uneasiness at the stomach and pain in
the region of the umbilicus ( see page 193 ).

Nocturnal Asthma of Indigestion. — In rare
cases the disturbance of the abdominal sympathetic is
80 great, on account of the formation of poisons in the
stomach and bowela, and the failure of the liver to
destroy them or the kidneys to eliminate them, tliat tbc
patient becomes the subject of dyspnea, or difficulty in
breathing, of the most distreesing character. The
attacks usually come on about midnight, — often be-
fore, but rarely later. The patient wakes suddenly
from sleep to find himself sitting uprigbt in bed.

204

THE STOMACH.

gasping for breath, and expecting every moment to
breathe hi a last. Tliese paroxysma are often ex
tremely distreesing, and not easy to relieve except by
the nse of the etouiach-tube, which nsnally quickly cuts
short the attack. A large bot enema is often of valao j
in these cases. Tlie reason for tlio occurrence of thisl
attack in the night is probably the lessened activity of I
the kidneys during sleep. During the daytime thej
poisons are eliminated with sufficient rapidity to ]
vent serious injury ; but the action of the kidneys bt
diminished during sleep, the poisons . accumulate infl
such quantities as to produce the symptoma referred to^. f
Those thus afflicted often experience relief after expel-
ling a quantity of gas from the stomach. Eating sup-
pers is also a cause of these attacks. The delay in the
digestive process occasioned by sleep gives rise to fer-
mentations and decompositions, to which the poisons
above referred to are due.

Treatment. — An iiscplic dietary ( Diet List No. 1 ),
from which flesh food of every description, including
fish, oysters, etc., is strictly excluded, is indispensable
to recovery in these cases. Cheese must also be
prohibited. The most prompt relief is occasioned by
a diet of fcumyss, kumyzoon, or buttermilk ( Diet List
No, 25). In many instances a milk diet is sufficient,
but in cases of dilatation of the stomach, milk is not
suitable, hence buttermilk or kumyzoon is to be^
preferred. From two to three quarts of buttermilltl
should bo taken daily. No other food but buttermilk,
or kumyzoon should be taken in severe cases, at least ^
for a few days after an attack. After three or four *
days, granose (Diet List No. 25) and cereal foods, <

BTUTOiuTia TSBATHXHT OF TSmammon.

with fruits, may be naed, but vegetables maat still be
avoided. A large hot enema should be taken daily,
and tlie patient ahould take as much exercise out-of-
doors as possible. A short sweating bath will aid in
the elimination of the poisons, but the hot bath should
be followed by a cool eliower, wet-sheot rubbing, or
sponge bath, as a skin or heart tonic. A hot and cold
full bath (21) is s most excellent measure for these
cases. Antiseptic charcoal tablets (49) should bo habit-
ually used in these cases, three or four being taken
after each meal. It is probable that nervous or es-
sential asthma is always due to poisoning of the nerve
centers by substances generated by germs in the ali-
mentary canal, and absorbed into the circulation,

" Stomach Cough." — This popular term has
really more significance tlian many pliysicians are sc-
cnstomed to allow. It is a very common observation
that the stomach and lungs sympathetically affect each
other. Most cases of consumption and chronic bron-
chitis are accompanied bj stomach disorder ; and, on
the other hand, there are many eaaos in which dyspep-
tic conditions are accompanied by a troublesome congh,
usually of a dry, hacking character, without expectora-
tion. In not a few instances of this kind the congh is
due to an elongated palate, or to congestion of the
pharynx. Most of the remarkable cures of consump-
tion by drugs are cases of this nature.

It must not be sujiposed, however, that every hack-
ing cough is due to disease of the stomach. Many real
consumptives make the mistake of thinking that their
congh is wholly duo to the stomach, and by procrasti-
nation lose their only chance for recovery. A cough

THE STOMACH

accoinpaiiied by copious expectoration, or by a rapid
pulse and night eweats, is rarely a *'6tomacb cough."
Serious dieiurbance of digestion is present, howeTCC».r
in nearly all cases of consamption. In fact, as a rnley,|
failure of digestion precedes consumption in nearly allS
cases ', hence in most cases of cobgh, except those iitjj
which the eyinploni ia duo to an acute cold, special at-:j[
teution must be given to the condition of the stomach.'?

Difficulty of breathing and a sense of suffocatioaa
are among tlio sjniptoma of dyspepsia in which thad
lungs are involved. The difficulty may arise from
pressure against the diaphragm by a distended stomacby'l
or through nervous influence.

Trmfment.^la these cases, the cough will he pei>a
manently relieved only when the digestive disorder isg
cured. Temporary relief may be obtained by the i
of the Perfection Vaporizer (59, 60). "GeneralToni
Trciitraeat" (see page 333 J and such other measures a
are indicated by the symptoms of indigestion whicbj
may be present, must be perseveringly employed. InA
cases of chronic cough, the vaporizer should be i
several times a day. Temporary relief may be ocoft- 1
sioned by gargling hot water in the throat for five tOjl
ten minutes two or three times a day. This is also j
a good curative means. Another excellent measure is 4
the throat pack, applied thus : First place on the throat:1
a cotton bandage consisting of several thicknesses ofj
cloth wrung dry from cold water, and of snfficier
length to extend around the throat. Cover this with-jl
several folds of flannel cloth of sufficient width toJ
extend an inch or two over each side of the moist band- j
age, wrapping as tightly as possible without interfeiva

ing with breathing. Thie applicatiou should be made
at bedtime. On rising in the mornijig, remove the
bandage, bathe the throat and chest with cold water,
and apply a dry flannel bandago to be worn during the
day. The persistent nse of this measure is one of tho
most effective means of relieving chronic irritation of]
the throat. In many cases a diseased condition of tha I
tonsils or of the posterior portion of the nasal cavity 1
IB present, and requires proper treatment by a specialist.

Nervous Symptoms. — Most of the symptoms
thus fur mentioned have related directly to the digest-
ive organs ; bat still other symptoms of importance
remain to be noticed, which may be termed "nervons
symptoms," us they are indirectly occasioned by ab-
normal conditions of the stomach and bowels. These
symptoms, akliougli they really arise wholly from dis-
turbances of digestion, are often supposed to be in-
dications of distinct and serious diseases of the nervons
system. There la no douI)t that faulty digestion iB «
one great cause of nervous disorders, owing to the I
fact mentioned, symptom? ut first temporary becom
chronic, and functional disturbances giving rise to3
organic diseases.

The nervous disorders which accompany dyspepsia
are due to four causes : (1) To sympathetic disturbance
■of function, through the nervous connections of the
stomach ; (2) to impaired nutrition of the nervous sys-
tem, defective digestion occasioning a poor quality of
blood ; (3) to the presence En the blood of the products
of indigestion, imperfectly elaborated food, acetic and
butyric acids, and other poisons resulting from the
action of germs ; (4) to retention of the excretions, ow-

THB 8T01(A.0H.

ing to the inactive condition of the liver, skin, and
bowels, resulting from bnpairod nutrition.

The injurioue elements mentioned, enming in con-
tact with delicate nerves already weakened by impaired
nntritioQ, increase their irritability, and occasion disor-
dered actions of almost every conceivable variety,
from the slightest degree of mental disturbance, as
abowTi in the confusion of thought observed by the dys-
peptic student or the forgetfulness of engagements by
the bnainesa man, to complete loss of mental control,
even actual insanity ; and from the alight nervousness
familiarly known as "fidgets," to the most alarming
convulsive action, as in epilepsy and hysteria.

Tr&itment. — The symptoms referred to in the above
paragraph should receive promjit and efficient attention,
as they may be t!ie beginning of grave nervous or men-
tal disorders. The treatment most generally required
is that indicated for slow digestion (see page 245).
The coloclyster (23) or a laxative enema f'25) not in-
frequently dissipates a distressing headache almost in-
stantly.

Nervousness. — Many dyspeptics suffer more or
less with an indescribable uneasiness, sometimes termed
"fidgets." The limbs are chiefly affected. The pa-
tient finds it impossible to sit still. The lower limbs,
especially, are kept in almost constant motion. Such
persons find the confinement of sitting in church almost
unendurable. This difficulty is especially troublesome
in the afternoon and at night. It is often accompanied
by peculiar aonsations in the limbs, especially when sit-
ting or lying, as "crawling," "prickling," "numb-
ness," etc., which are sometimes thought to indicate a

STVPioiiATio TBKATXBST OF iDDiexernotr.

tendency to paralysis, but are merely signs of a weak-
ened circulation and badly nourished nerves.

An alliod and very singular sensation is that of 1
motion. The patient, if very nervona, — and thia is
especially the case with young women, — will often
complain of feeling as though being carried involun-
tarily to different parts of the room, as from one corner
to another, to the coiling, to the window, or even into
another room. Patients sometimes complain, also, of
feeling as though some portion of the body were larger i
than natural ; as, when lying down, the senaation will l
be that a limb, or a band, or the head is immensely J
lai^e. TliQ delusion vanishes, however, upon the pa- 1
dent's attempting to move the particular part affected.

Treatment. — Hot and cold B|ionging of the spine \
daily (18), fomentation (10) over the abdomen at night,
followed by the moist abdominal bandage (9) to be
worn diu-iug the night, the cool morning sponge bath
(1), and the abdominal supporter (45) are the best
means of palliation in these cases ; hat a thorough
course of treatment and training at a well-equippod
and scientifically conducted eanitarium is essential for 1
a cure in most cases. General nutritive (page 331) c
tonic treatment (page 333) should be employed.

Disturbances of Sight, Hearing, etc. — Noth-
ing is mure common in this disease than dieturbanceB |
of vision and of the various other special senses. Dim-
ness of vision, deafness, ringing in the ears, extreme' fl
sensitiveness to noise and also to light, occur in many'l
cases. Not infrequently the patient sees imaginary I
forms of various sorts. Sometinios the intolerance of J
light is BO groat that the patient wishes to remain in i

310

TBK ST^KACB.

dntr

TUi isinon ccnunoa m vantni thaa
mni. Oftes tfat* eztreioe degne of apparent »eDsin«'e-
aeat ii mote imapnmrj tfasn reaL The appearance of
biaek or brij^ qxMs f>( v-arioaa shapes and eizes, espe-
eiallj noted when atoopai^ orer, is amttlKr roiumou
•ymptom. CTDDStBral tfairat, perret Bi ona of taste, pe-
mltar amshiTeiKss of varions porta of d»e bodr, are
also srniiMoinfl worthr of notice^

Treatment. — lo extreme cases, the "Resl-Cnre"
(page 32S). followed br prc^reaM^e application of
□Dtrilive and tonic treatment ( pages 331 and :Mi:i }, ia
required in addition to the application of each palliative
measnree as nia,T be indicated b; the geoeral and local
ftymptoms presented.

Ner\'ous Diseases. — Fanctional neixoos disor-
ders, as hysteria, epilepsy, and even temporary pa-
ralysis, often originate in dyspepsia. Dr. Chambers,
an eminent English physician, asserts that nine cases
ont of ten of hysteria are due to Uidigestion. This
statement I have found nbandantly confirmed by ray
own observation. In the treatment of epilepsy, I
have observed in many cases, tenderness at the
pit of the stomach, and a foul tongue. In some in-
stances, no doubt, the stomach disease is secondary ;
but many times, at least, I believe that the latter
difficulty is tlie primary affection. In many cases
the remedy given to cure the disease is of a character
to defeat the end desired, by deranging the stomach.
The long- continued use of bromides is certain to derange
the digestive organs, as this drug lessens the activity of
Iho glands of the stomach. AVlien bromides are used,
a good intestinal antiseptic should be constantly em-

BTMPTOMAtIc TBEATMKST ok IKDIOE8TION. 211

ployed, as a means of preventing the fermentation of
the food substances tlirough the action of microbes
which are I(>ft to develop in consequence of a deficient
supply of hydrochloric acid in the gastric juice. Anti-
septic charcoal tablets are most suitable for this pur-
pose t49).

If the tongue is coated, the treatment recommended
for septic indigestion (page 251 ) Bhoald be employed.
Careful examination should be made in relation to the
condition o£ the stomach aa regards dilatation (page
2I.^(. If possible, a test meal should be given and the
stomach fluid examined, as mnch light is by this means
often thrown upon the nature of the disease presented
( page 184).

Unusual Drowsiness. — This symptom occurs
most often after eating, though it is aometime8_ almost
continuous. An hour or two after eating, the patient
feela an almost irresistible desire to sleep. The sense
of weariness and lassitude is sometimes so great that it
is with difficulty that the person so affected can be in-
duced to make an attempt to exercise. If he does so,
however, he feels much better than if he yields to his
desire to sleep. Exercise dispels the exhausted feel-
ing, which is not fatigue ; while if the patient allows
himself to sleep, he awakes unrefreshed, and feeling
really worse than when ho lay down. In these cases,
drowsiness is duo to the development of poisonous
substances through tlie action of germs upon the food,
and their absorption into the system.

Trmtim-nt. — This symptom, often very trouble-
some, ia frequently due to overeating, and is promptly
relieved by eating a smaller quantity of food. Kjipid

eMuig is another common cause. The hot and cold
trunk pack is a raloable toeasare of treatment, also
fomentations to the abdomen, the moist abdominal
bandage at night, and plenty of ootdoor exercise.
The meaaoTvs recommended for '* Simple Drspepeia,'"
or slow digestion { page 245 ), should be emplojed. For
temporary relief the patient shonld drink ono or two
gtasBos of hot water, and practice decp-brestbiog ex-
ercises (38).

Sleeplessness. — This condition, quite the oppo-
site of the preceding, is equally common, and often ex-
ists in the same individoal, the person being very
sleepy soon after eating, bnt wakcfal at night. The
patient is not kept awdie by pain, but by simple
norvoDBiicsB, by a sense of weight at the stomach, by
morbid anxiety or fears, by burning of the feet and
hands, or some similar cause. If sleep comes, it is
not Bonnd. There are troubled dreams, and tho per-
son awakes in the morning nnrested and nnrefreshed,
Tlicse patients usually feel best in the afternoon and
early evening.

In most cases of chronic insomnia tlie patient will
be found to present a very foul tongne. There ia
often dilatation of the stomach, and generally many
other symptoms pointing to disturbed digestion as the
real cause of the sleeplesaness.

Tiviiiintiit. — Lavage of the stomach, the employ-
ment of a strictly aseptic dietary ( Diet List No. I ), —
it may be necessary to discai-d even milk if tho stomach
is dilated,— the use of antiseptic charcoal tablets (49),
fomentations to the abdomen at night, the wet girdle (9)
worn during the night, and " General Tonic Treatment "

BTltFTOHATIO TEEATlfKNT OF ISDiaESTION,

213

( page 333 ) are the meaBorea specially indicated. The
sleeplessness is thti result of tLe circulation in the
blood of substances of an irritating or exciting char-
acter. An aseptic dietary prevents the development of
these poisons, and their elimination may be aided by
copiouB water- drinking, exerciae (37) in the open air i
suHiciont to cause perspiration, breathing exercises (38),
a light sweating bath onco or twice a week (16, 17),
fomentations over the stomach and liver (10), snn or 1
electric- light batlis (15), whereby the skin is stuuu-
lated, etc. The Natural Abdominal Sapporter (45), '
in casea whicli require tt, affords greiit relief.

TUia most annoying and exhausting symptom -
sleeplessness ^- also requires attention to ttie following J
suggestions : —

1. Retire early, having taken, an hour or so before,
safUcient muscular exercise to induce slight weariness. '

2. Eat nothing within four hours &f bedtime. Go-
ing to bed without supper is perlmps the best of all 1
remedies for sleepleHsuoss. If theru is a faint feeling m
at tlio stomatrU, drink half a glass of hot water. If J
this does not suffice, a mellow, sweet or subacid appla J
may be taken an hour before retiring, unless fruit oe- i
casions pain or acidity, in wliieh ease one or two tableta |
of bromose may be substituted. '

3. If feverish, the skin being hot and dry, take a J
light hand bath with tepid wator upon retiring.

4. If the feet and hands are cold, employ the mi
elsewhere suggested for this condition (page 191).

5. Sleep in a cool room, taking care to see that the
bedding is well aired and dry, and the room well
ventilated.

214

THB STOMACH.

6. When nervouaaess caases loss of sleep, there
are various methods of inducing Bhimber, one of the
most efficient being slow, deep, and steady breathing.
By this means the lungs are filled with blood, and the
brain is thus relieved of the congestion which causes
wakefulness.

7. When the head feels cold, the indication is that
there is tiot enough blood iu the brain, and the head
should be protected by flannel coverings. If the head
is hot, a cl()th moistened in cool or cold water may be
applied, the hair being first wet.

8. In case the head is hot and full of blood, sleep
may often be induced by raising the head of the bed six
inches or more above the level of the foot. If tho face
is pale and the head cold, xhe foot instead i>f the head
of the bed may Ijo raised.

9. For sound sleep, the sleep ing-room should not
bo too warm, anJ tho patient should not be too warmly
covered in bed.

10. Avoid exciting conversation or reading shortly
before retiring.

Mental Disorders.— Until of late years it was
not known that dyspepsia could be recognized by the
mental and nervous symptoms alone ; and even yet the
fact is not as well understood as it should be. It is
tlioroughly established, however, at the present time,
that this is the case, and also that when the mental and
nervous syinptoins are most prominent, those whioli
point directly to the digestive organs are the fewest
and moat obscure. Hypochondria has long been
associated with indigestion, though often attributed
to the liver. Students, clergymen, and other mental

STXFTOICATIC TSBATMSKT OF IMDIOSeTtDM.

515

workers whn Buffer from cerebral hyperemia, or chronic
congeetioQ of the brain, are nearly alwaya victimB of
iudigeetioa, which resultB in defective nutrition of the
nervous Bvetem. Gloomy apprebenBiona, forebodinga,
poeviahnesH, perveraity of disposition, religious despair,
confusion of thought, loss of memory, abac nt- minded-
neee, and many other forma of mental disturbance are
justly attributable to this cause, and disappear upon ita
removal.

Tiie failure on the part of many physicians to
recognize tliia c-laas of cases has consigned many men
of ability and influence to insane asylums, with no
hope of recovery, who might have been Bavcd to the
world, their families, and themselvca by a judieioHsly
directed course of treatment. Hnndreda of nervous
women who have had their spines blistered and burned
and cauterized for sonio supposed obscure nervous
trouble, enduring years of torture, all without benefit,
might have been made well by a few months of intelli-
gent treatment for impaired digestion. A largo number
of botli classea of invatida have come under my care,
some of whom had been inmates of insane asylums
for years without recovering, while others had baffled
the skill of eminent neurologists ; and having seen a
large number of these cases recover mental soundness
under rational treatment and with regulation of the diet
and regunen, I am convinced that much more attention
should be paid to tliia class of dyspeptic cases. It is
gratifying to see that particular attention is given to this
matter in some of the best-regulated insane asylums.

Dilatation of the Stomach. — This condition
is one which has, until recently, been rarely recognized.

, 210

THE STOMACH.

Ten or twelve years ago Glonard, an eminent French
phyaician, called attention to the freqnencj with which
both dilatation and prolapse of the stomach occur. By
carefnl observation and logical deduction, Glenard
showed that a large share of the must obstinate symp-
toms encountered in dyspeptics is dependent U|>on a
disturbance of the functions of the stomach arising from
dilatation or prolapse of tlie organ. The principal
canso of prolapse is constriction of the waist by corsets,
tight skirt-bands in women, and the wearing of belts in
men. In conjunction with dilatation and prolapse of
the stomach, one or both kidnevg are frequently found
prolapsed, tlie colon fallen below its normal position,
and not uncommonly folded upon itself, and the liver
and spleen also displaced in a downward direction.
The consequences of these displacements are far more
serious than any other visceral displacements which
can occur in the body. Dislocation of the womb or
ovaries in women, or the dislocation of a joint in either
sex, is a matter of small consequence compared with
displacement of the 8t()macli, the liver, or the colon.
Space will not here permit a consideration of all the
symptoms which may grow out of these displacements.
Suffice it to say that most of the numerous symptoms
previously described as observable in indigestion may
be the direct outcome of displacement or dilatation of
the stomach, or prolapse of the other organs of di-

la prolapse of the stomach and other abdominal
organs, the fact is in many cases quite apparent from
the external form of the body. The waist is nsnally
flat or depressed, and the lower abdomen exceBsively

SYMPTOMATIC TKEATMENT OF 1NDIOE8TION. 217

prominent. In addition, there is usually a forward
carriage of tlie hips, round shouldei's, depressed chest,
with undue prominence of the spine between the
slioulders, and forward carriage of the head. This
condition is a prevailing one in women who have worn
the ordinary conventional drees. A very common
symptom of dilatation of the stomach is a plaeliing
sound hoard in walking or when rocking in a rocking-
chair after swallowing a quantity of water or otiier
fluid. Some illustrations of cases of dilatation and pro-
lapse of tlie stomach and otiier organs associated with
indigestion, are represented in Plate IV,- page 133.

Treutmeiit. — In tlio treatment of this condition the
most important measnrcs are : —

1, Sufficient loosening of the clothing to permit
proper expansion of tl»e body at the waist, thus allow-
ing the prolapsed organs to return to their normal
position. For suggestions respecting proper dress,
which is very essential to the cure of indigestion in
women, see page 123,

2. The support of the lower abdomen by means of
the Katurat Ahdominal Sapporler (^S), whereby the
displaced viscera are lifted up into position. The
action of the supporter is practically identical with
that of the hands when used to lift up the abdomen, —
a practice to which many such sufferers resort as a
means of relieving uncomfortable, sinking, dragging,
and other distressing sensations experienced in the
lower abdomen. The employment of artificial sup-
port, however, is not sufficient to accomplish all that
needs to bo done in these cases. The viscera nmst be
replaced by massage applied by u pkilled masseur or

'218

TBE STOMA OH.

who lias been taught the normal poeilion of
the viscera, ami how to distingnish each organ by
palpation, and restore it to its normal position. By
the employment of raaasage, the abdominal muscloB
may also bo strengthened, a dilated stomach otDptied,
and congestion relieved (31, 32, 33)-

- 3. The ajiplicatiou of electricity, particularly by the
einuBoidal current," to the abdominal rauselua, whereby
they may bo exercised and Btrengtbened. I have
foiind the application of tho sinusoidal electrical cur-
rent to the interior of the stomach, an excellent means
of treatment in cases of dilatation of that organ. The
application is made by parsing a conducting wire
through a stomach-tube introduced into the stomach.
In one case in which every other metwure had failed,
the patient was iu this way rapidly and permanently

' benefited (67, BS).

4. Carefully graduated exercise, particularly mannal
(42) and mechanical Swedish movements (page 3''i4),
which in an inipoilaut means of developing the musclea
of the trunk in cases of this class. Bicycle riding and
boating are also to be recommended, if employed Intel-
ligently, and not indulged to excess (37).

5. All aseptic dietary ( Diet List No. 1 ) is abeo* •
lutely essential in these cases, and should be licrtipu-
lously adhered to for an indefinite period. For three

' or four weeks the patient should be confined strictly to
R dry diet ( Diet List No. 2 ), no fluid whatever being
allowed at meals nor until five or six honrs after eating.

•For a dcscrii>t1on of Iho Slnusoldnl Carrent, discovered by the
BOUior In 1883. Mw "Tbe Grapblc Study of ElKvlrlc&l Curronis In Bt>la-
tlon to TbprKpeutlca. villi tipeclal Refer^iicp to tbe Sluiuoldal Current."
Hodeni Medicine PubllsbluB Co., Buttle Creek. MlcL.

BTIEFTOIUTIO TBEATHSHT Or IBDieBSTIOII. 219

Indeed, little fluid sliould bo taken into the stomach at
ally time in tiieao cases. If the patient is thirsty, the
thirst may be relieved by introdocing water into the
bowels by means of the enema.

A person suffering from diSatiWion of the stomach
should avoid swallowing plum stont^s anil cherry pits.
Tlie stomach of an adult German was found, at the
aiftopsy, to contain nine hundred and twenty cherry
pita and seventeen pimn stones, which had been re-
tained for at least eight or nine months.

The writer has succeeded in curing two cafies of
exceedingly bad prolapse of the stomach by a surgical
operation. The abdomen was opened by an incision
extending from the lower end of the sternum to the
umbilicus. The stomach, the lower border of which
lay several inches below the umbilicus on the right
side, was pulled into position, the lower border lifted
as high as possible, and sutured to the median line by
means of four silkworm-gut sutures, wliich were left
buried in the tissues. A floating kidney was also
found in one case, and sutured in position. Both
patients made good recovery. The tongue, which
had for years been extremely foul, became clean in a
short time, and other disturbing symptoms which had
been present for years soon disappeared.

Another method which has been employed is the
enfolding of a portion of the dilated stomach. It is
said that the enfolded portion disappears in the course
of time, Stu'gical measures are seldom required, how-
ever. I have succeeded in restoring the prolapsed stom-
ach to position and greatly diminishing the size of a
dilated stomach in a great number of cases, by purely

TREATMENT OF DYSPEPSIA.

As dyspepsia is not usuallj a fatal disoasG, thoa- I
sands of people allow themsetvea to suffor from its
pains and inconveniences for years without making
serious efforts to recover. If anything is done, it ia
most likely to be a trial of some qnack nostrum ad-
vertised on the fence or heralded in the daily news-
paper as a "sore cure" for indigCBtion, its merits
certified to by a long list of fictitioas or purchased
testimonials. Of course every effort of this sort makes
the disease worse in the end, even though there may
be apparent temporary relief. The sufferer finally
settles down to the melancholy conclusion that liis
malady is incurable, and thus lives along in a
wretched way nntil consumption, tliut dread disease
whicli often follows close on the heels of the hydra-
headed malady we are considering, claims him as a
victim, and ends his misery.

The importance of giving serious attention to the
treatment of this disease is further proved by the fact
that many organic affections which, when once well
established, it is impossible to cure, have their origin
in indigestion. This is undoubtedly true of tuber-
calar degeneration of tJio lungs and of other degen-
erative changes in various parts of the body. The
same may also be said of many nervous affections.
This accounts, in part at least, for the almost constant
[221]

292

THK 8TOHACH.

association of impaired digestion with consumption
and various organic affections of the liver, kidneys,
and other orgiins. In most of these cases, the best,
sometimes the only, hope of a cure lies ia the treat-
ment and cure of the digestive disorder ; and, without
donbt, if this euold be accomplished sufficiently early,
many cases of hopeless organic disease of the lungs
and other organs might be prevented altogether.

The djBpeptic, of all invalids, needs to enter upon
the work of getting well wilh a determination to suc-
ceed, and with a resolution to do all in his power to
accomplish that end. Though an intelligent physician
can do much, the patient can do vastly more for him-
self than any one can do for him- Indeed, he alone
can control many of the conditions esaential for the
happy termination of his Bufferings. If the dyspeptic
would recover, he must seek carefully for each of the
causes of his disease, and remove them. It is of no
use to hope for recovery without doing this. If the
cause is in the manner of eating, let him take care to
eat properly. If he has erred in eating too much, or
in eating improper articles of foixl, let him make a
thorough reform in this regard. If the difficulty has
been in overwork, too much anxiety, too little time for
digestion, or too sedentary habits, he must get away
from his care, his business, his writing-desk, and seek
health in. outdoor exercise, with happy, cheerful asso-
ciatioDB. The careworn, burdened mother must have
relief from the tedium of her routine life. A journey,
a visit to a friend, or eome other means of diversion
must be adopted. Whatever the cause has been, it
must be removed. No medicine known, no matter how

TEEiTMENT OF

223

I
I

potent nor how skilful its administration, can antidote
the effects of the transgression of physical laws. Na-
ture is inexorable. She demands obedience, and will
not 1)0 put ofE with any subterfuge.

The dyspeptic must also remember that it is not
only his stomach which is diseased, but that every cell
and fiber of his body is more or less injured by the fail-
ure of the stomach to supply proper nourishment for
rebuilding the tissues, or by poisoning from the products
of fermentation and decay which have been absorbed
from the dilated or prolapsed and sluggish stomach.

It must not be expected lliat recovery from the con-
sequences of a disease of many years' standing can be
effected in a few weeks. Getting well is a process of
growth, as much as the raising of a crop of corn or
the development of a tree. The diseased stomach must
lie grown out of its vicious ways and into a healthy con-
dition, under the influence of correct habits of eating
and appropriate conditions nf regimen and treatment.
Many symptoms which have been long establislied will
persist for some time after proper treatment has been
established ; but this fact must not discourage its con-
tinuance. The patient should weigh himself at the
beginning of treatment, and thereafter at least once a
week. Loss of flesh for the first few weeks must not
be a cause of discouragement, however, as it is a fre-
quent occurrence. A gain in flesh may, however, be
regarded as one of the most promising symptoms in
cases in which any considerable degree of emaciation
has existed.

It must not be supposed that any one plan will ac-
complish the result desired in all cases. There are
IS

:i24

varione forms of dtBpepaia, each of which requires
special mauagemeDt, though the general principles laid
down apply to all clasaea of the disease.

Diet and Regimen. — In the treatment of this dis-
ease, proper diet and regimen are of first importance.
It is necoasarr, however, that thoy should be moat care-
fnlly adapted to the wanta of each individual case, as
nothing is timer than tlie old au-laga that '*what is
one man's meat is another's poison," when referring
to cases of dyapepsia. The common plan of recom-
mending some special dietary to all dyspeptics indis-
criminately is a most pernicious one. We hear much
of tho "grape cure," the "beef cure," the "fat cure,"
the "cod-livor-oil cure," the " miik cure," and sundry
other special diet cures of dyapepsia, as well as the
"vegetarian cure." Each of these diets may be of
eerviee to some special case, but all aro totally unfitted
for all cases alike.

It is not an easy matter to induce individuals suffer-
ing with dyspepsia to deny the demands of appetite.
In many cases the ajipetito is perverted, and the will is
80 weakened by long-continued disease that the patient
loses aelf-control, and thus himself constitutes the most
dilBcalt obstacle in the way of his recovery. If a cure
is expected, the directions given must bo followed im-
plicitly. In no other way can a confirmed dyspeptic
hope for recovery. All bnt one or two requirements
may be carried out, yet fuiluro in one particular be
sufficient to make all other efforts useless.

Dietetic Rules. — Although there is no such thing;
as a universal diet for dyHpeptica, there aro certain arti-
tlfjs which must be discarded by all j^reonii who havQ

TRBATUENT OP DTSPIPStA.

335

weak digestion, and certain dietetic mlea which must
be conformed to bj all. To the most important of
these attention is now called.

1. Eat slowly, masticating the food very thor-
oughly. The longer the food remains in the mouth,
the less time it will spend in the stomach,

2. In general, dyspeptic stomachs manage dry
food better than that containing much fluid.

3- Avoid drinking at meals ; at most, take a few
sips of warm drink at the close of the meal, if the food
ia very dry in character.

4. Be careful to avoid excess in eating. Eat no
more than the wants of the system require. Sometimes
less than is really needed must Lo taken when digestion
is very weak. Strength depends not on what ia eaten,
but on what is digested.

5. Never take violent exercise of any sort, either
mental or physical, just before or just after a meal.

6. It is not well to sleep immediately after eating,
nor within four hoars of a meal.

7. Never eat more than three times a day. and
make the last meal very light. For most dyspeptics, as
well as healthy adults, two meals are better than more.
Tlie length of time between meals shonld not be lesa
than seven hours, unless a special dietary is followed ;
S : 00 A M. and 3 : UO p. m. are suitable times for
raeala.

8. Kever eat a morsel of food between meals.

9. Never eat when very tired, whether exhausted
from mental or physical labor.

10, Never eat when the mind is worried or the tem-
per ruffled, if possible to avoid doing so.

11, Eat only food that ie easy of digestion, avoid-
ing compliuBted and indigestible dishes, and partaking
of few kinds at a meal. In severe cases it is often nec-
essary to confine the diet for a time to one or two arti-
cles of food which are the most easily digested and
asaiinilated-

12. Must persons will do well to discard the use of
meats, and add to their bill of fare an increased pro-
portion in quantity and variety of cereal foods. The
foods manufactured by the Battle Creek Sanitarium
Health Food Company, are to be highly recommended.
They have been prepared especially for the use of in-
valids with feeble digestion, and are just what they
claim to be. Tlio writer baa prescribed tbeni in many
thousands of cases, and finds them indispensable in
the treatment of the hundreds of invalids witli disor-
dered digestion who come uuder his care amiually.

As an aid to the reader in the selection of a diet
suitable to his c&so, the following diet lists are pre-
sented, which it is hoped will be found helpful : —

DIET TABLES.

The following is a list of dietaries which are based
upon observations made in connection with the exact
methods of analysis of stomach fluids and the study of
digestive disorders, to which reference has already
been made. They have been tested in the treatment
of many thousands of invalids at the Medical and
Surgical Sanitarium at Battle Creek, Mich., and have
proved highly satisfactory. The made dishes called for
are cooked in accordance with recipes given in "Sci-

I enco in the Kitchen," by Mrs. E. E. Kellogg, A. M.,
[ published by the Modem Medicine Pah. Co., Battle
[ Creek, Mich.

ASEPTIC DtETARI'.

EupGcially adapted to caucs iii which fermentation is

I present, alao in caseu of clirouic biliousness, sick-head-

, jaimdicG, Bright's disease, gastric and intestinal

I catarrh, simple dyspepsia, most cases of hyperpepsia,

-End cases of hvpopepaia not of extreme degree.

Sterilized FocmIs Prepsrad without HIili or Egfs.

P»s purJP.

Macaroni with uim

to Bromoso.

LeulU purif.

saui.-t'.

Nut porridge.

Btana puric.

Fruit toast.

Nut butter.

Nuts puH«.

Vegetable broths.

Corn son p.

aterllUod butler.

Oriinola.

GRAINS.

Gruham musb.

Barley gruel.

Boiled rye.

Hlxcd niDBli.

Oracliea wheat.

Bice water.

Olulon musb.

Boiled wheat.

Granolamnsh.

Molded wheat.

Browned rice.

HoidId; flakes.

Pearled wbeat.

Hulled corn.

Oatmeal blBDC-maDge.

Boiled wboat.

Gluten.

Gluten wator gruul.

Orabam gtltn..

Grains of gold.

GrshBniKrlU Bfel.

Bran Jelly.

Hominy.

Corn-meal btuuI.

Grain Jellj.

Popped Corn.

Orabam gracl.

Jellied oatmeal.

Corn goflu.

Oatmeal «ruel.

Boiled oals.

Wbeatgoflo.

Split pea Kup,

Baked potato.

Pnlp succoiasb.

Lentil Houp.

Green peua.

Kornlet.

Lentil toast.

Orjstal nbeat.

OraiKme brown bread.

Btltlts.

prepared wltbout

Zwieback.

CrUp§.

FRESH FRUITS.

milk.

OiapM. Bvrrles,

feaubes.

Pearg. Melons.

Balslns. irbetrlrs

Figs. Dates.

Apples. Outrau.

Plaeapples,

.Bananas,

THB erOVACB.

Baked apple deawn
Baked lomato.
Prnne mann&lade.

Slewed pro net.
Slewed nlslns.

Apple Jelly wltkont
Cranbeniu and

Apples (t««ed wtth

FRUITS COOKED WITH SRUHS.

Pculed wheat with

Rice with ralsiD*. Balain grnel.

Pearled taftey with

Urtiham grll« with touoatoiaD

ralslm or flgi. Banaiu (oast.

Cracked wheat wlih

Graham apple miuh. Tomato loasu

FnHiia with Bg ^m-c.

Farina with fresh fruit. Prune pie wlih

Rl<;« with Us «m-e.

Pcmclied egg». trmniiiji I'ru

B> F4M>d§ which Eocoiinge Asepsis of the Stomarb and InUatiiies.

All the articles named in the preceding list of ater-
ilized foods prepared without milk or eggs, with the
addition of the following : —

Hedlnm boiled egip.
Beateii whites of egg>'

Soft bollMl ei
Beaten wboli
Cottage cheei

C. Foods which do not Fermeiit in a Stomaeh oT
Moderate DlgestlTC Ti|ror.
All the preparations of grains, fruits, milk, eggs,
and easily digested vegetables in Diet Lists Nos. 1 to
10, only raw milk excepted.

With tliis list it is necessary for many patients who
have lung aiiffored from dilatation of the stomach, to
employ some intestinal antiseptic, of which the best is
charcoal, in the form of antiseptic charcoal tablets (49),

DIET LIST NO. 2.— DRY DIETABT.

A dry dietary is indicated in cases in which there is
dilatation of the stomach, with slow absorption. In

TRBATUBNT OF

cases of this sort, Hqnid foods remaiti t(Hi long in the
Btomacb.

The chief pnrpoee of a dry dietaiy ie to secure thor-
ough mastication of the food ; hence the articles in the
following lists should be taken without water, milk, or
other liquid. Granose is an ideal article of food for a
dry diet, as it stimulates the ilow of saliva to a greater
extent than any other food with which we are ao-1
quainted. Granose, combined with nuts, nut meal, '
bromose, or the yolks of bard boiled eggs, may often
be oaten with advantage almost exclusively fur a few
days at the beginning of a course of dry dietary,

A. Drj Met-

This list includes all the unfermented brcadx I Diet
List No. 13), and in addition, —

Yolksot hurd boiled eggs. Bromose I dry }. NutbaU'T.

Gmiiost. Popped corn. Nudneal.

Stuniued ags. Sterilized butter. Roosted ;>ltuuuils.

B. Modified Orr Diet.

This list includes all the preceding list ( A ), and in i
addition the following : —

Boiiten whole BKgs.

Poanhed eggs.
Card led egg^
Floated vggs.

Popped corn.
Musbed pens.
Masbcd beans.
Stewed prune-i.

DIET LIST NO. 8.- SITB0GEN0II8 DIETARY.

The nitrogenous elements of food are also pepto-
gens ; that is, they stimolate the secretion of gastric
juice, and hence foods of this class are especially
adapted to cases of hypopepsia and ajiepsia, in which

230

THE 8TOUA0H.

the production of gastric juice is alwaja deficient. Al-
bumeu and casein are the most important nitrogenous
eletnenta. Egga consist chiefly of albumen ; milk con-
tains casein in abundance ; nnts are rich in aibumcu
and vegetable casein ; peas, beans, and lentils contain
a very large proportion of vegetable casein. At the
beginning of a course of treatment, in extreme cases of
apepsia and bypopcpsia, it ia sometimes necessary to
confine the diet to a single nitrogenous food, as kumyss
or knmyzoon. Later, eggs may be added advanta-
geously, then some farinaceous food, as gruuose, with
nuts, and still later the various unfennented breads and
soft grain preparations ; but dry foods are to be pre-
ferred.

Beans cur€c.

PifHS purtc.

Nats puHu.

Milk (Diet List No. ».

Almund meal.
LbdHIb with iiu

This list consists oxchisivcly of fai
tious of a character easy of digestion.

Crenm rice soup.

TKBATMBNT OF DYBPBPaiA.

Glaten mash.

MacaroDl baked vlt h

Burlvy gruvl.
tii^bara grits grui-l.

Oatrntal grael.
UllkKTiiel.
Gruham grnvl.
Com-nnml grncl.
Outmeal porridge.

b1 blanc-muGge,

JelllHd uutmeul.
Barley milk.
Milk panadu
Bran Jelly.

Rice molded.

Bice water.
Gralnjeilj.
Cracked wbeai.
Uoldcd wheul.

Oranoli.
Bullpd outB.
Hollud rye.
Puarled wliiuit.
nulled Liirn.
Popped curi).

Hominy (iHkcs.
Corn RuHo,
Grains uF gold.
Cryntal wbeat.

DIET LIST NO. 5.— Mn,K.

DIET LIST SO. n.

TLis list is composed entii'ely of ]>reiiaratioiis of j

Hedlutu bulled eggs. Soft boiled eggs. (.'urdlei

lliird boiled yolks ot eggs. Poached pggs. BeHU'D

The articles in this list contain milk or some cei

preparation iu addition to eggs.

Gluten custnrd. Oranow custurd. rnsum toast witl

OlutsR meal custard. Rice castard. poncbed eggi

Bread cnstard. Rim with egg. Poat-lied uggs on

Parlns cnstard. Crucked wheat cuslurd. foii*t.

DIET UST SO. 7.

Foods which iiro easily disintegrated, and hence .
to ca^es of dilatation of the stomach.

UNFENMENTED BREIOS.

(Ulct List No, 13.)

THE BTOHACH.

Broimed rice.
Corn BoBo-

FRESH FRUITS.

GrupU!.. Uriniges.

FRUITS WITHOUT BUOMR.

Baked apples. Nli

(wed pruues. ITune dessert. Prult iubM. j

FRUITS COOKED WITH GRIINS

Graham peach mush.

MlicaroQl with tomato

Orahum grIU with

Grape mnsh.

rablna, dales. Op

Bran Ola gmpo mush.

BIce with fig sauee.

Act.

Oatmi>a! truH mubh.

Farina with fig suuce.

Rife with raisin*.

Granoln fruit mush.

Pearled barley.

Wheat with herrlM.

Orunola pt^acJi muitb.

Qrape toast.

Farina with tro»h

Graham apple mush.

Blackberi? math.

Banana t«ust.

Bice and stewed

apple dessert.

miub.

Apricot toaiit.

Cracked wheat wtUl

Oranola apple mush.

Berry toast.

»t«amod apple. '

Lemon barley gruel.

Poath toust.

Baspbcrrf grila gruel

Farina fruit mold.

swwed fruit puddl*

Raisin gruel.

Bed rlee molil.

Wheat with peacluft

OraiiUBruel.

Pearled wheat with

Riee with peachB*.

Lemon gluten gruel.

Prune pie with gra-

Lemon oatmeiil gruel.

Peurled barley with

nolB erust,

Boiled wheal.

VEBETHBLES MD LECUHES.

Grunoae sbortctke.

Peas purie.

Oreeo peas.

Kornlct.

Lentil pur^.

Vegetable broth.

8pllt |»H8.

Corn pulp.

EGGS.

NulBwItbiontlla.

UedlnmboUed eggs-

Poachud ugRs-

SoftboUedegga.

Beaten nhites of oggB.

Curdted eggs.

Beaten whole c«gi.

Bard boiled yolks of eggs. Flonted eggs.

■IISCELUUIEDUS.

Now Cru KumrKi.

SUrlUied butter.

Nut butter.

Knmjiooii.

Nut meal.

DIET LIST KO. 8.— AHTI.FAT DIETARY.

An anti-fat dietary need not neceBBarilv exclude all
starchy foods. The moet important points to be ob-
served are —

THSATHBNT OF DTBrBPfllA.

333

1. Limitatioii of food to the smaUest amount with
which the strength can be maiDtained.

2. Restriction of the diet to one article, or at most
to two or three.

3. Avoidance of fats.

4. Avoidance of liquid foods of all sorts. If ku-
mysB or kamyzoon is used, it abuuid be made the chief
dietary.

GrHDOsL' (oatentlrj).

Oluu-n,

Celery <ooo

Hard rolb.

Gluten biHcult.

Tomaloes.

Medium bollod eggs.

Gluten ouslard.

String belli

Booteii whites ot eggs.

Sour apples.

Poached eggs.

Oranges.

OrecDS.

Curdled eggs.

BtTBW berries.

Sticks.

FloBled eggs.

. BunuaiLS.

Zwieback.

Son boUed eggs.

DIET LIST NO. D.-FAT AXD BLOOD DIETARY.

Those foods which abound in starch, sugar, dex-
trin, aiid easily digested fata, are the moat conducive
to fattening. At the head of the list stands bromoae,
which contains one fourth its weight of emulsified, or
partially digested, nnt fat, and nearly forty per cent, of
digested storeli. The following articles are fattening
in character : —

Fruits and Nuts (Diet Diet List No. T.
Lint No. m. Diet LlKt No. 13.

Diet List No. C Bromose.

DIET LIST NO. 10.— FEDITS AND NUTS.

Grapes.

Oranges.

PcBcbea.

Pineapples.

Bans nils

RalslDS.

Apples.

Cherries

is*

THE STOMACH.

B.-FRUITS COOKED WITHOUT SUGAR,

Baked apples.

Htvired raisins.
Applesslpwi'dni

Usked iKurs-

Appli'ji-113' without
tliralslns. sagni.

ITimE d^aserl.
Ptuw marmalade.

C.-FHUITS WITH SUGAR,

Crunburries and

»*«etapplo*
liakeil apple deisert.

j-U'Wed prune*.

l-TifiTmenlc-dwl:
liluiwvd fruits.
(.luiQwl fruits.

BL-. 0«pcjeily.
Fruit Jalces.
B»k«l.iuluce.

D.-NUT8.

LcmoD apple.
fltron appl«.
Bunaiias tu fruit
sirup.

Mmoaas.
n\ckary tints.
FllborW.

rhestnutBbullcil^jr
Almond meal.

Nut meftl.
Nut porridge.

DIET LKT NO. II.— LIQUID DIETART.

A liquid dietary is especially indicated in fevers, j
and iu some cases of painful dyspepsia, especially ca
of hyperpapsia accompanied by much irritation, aa in- '
dicated by pain on pressure over the pit of tbc stomach |
and pain after eating. The purposu of a liquid diet is t
to present nutriment in a form wluch will tax the 8to
ach as little as possible, and secure the early emptying'!
of the stomach by the passage of its liquid contents ]
into the small intestiui'.

Olutcn KTUul. Fruit Juice*.

KumysB.

Malted Kluten eruel. Burle? WBl«r.

Kumysanog.

Fruit and unts gruul. Nut porrldgi;.

Kamyuwu.

Nols and gluuin gruel. Cruam.

Cottasc cheese.

VegoliibIesoup{p<.'a,lonl[I, Hot nillk.

Curdlisd eggs.

IWBU, lamatu. rlue.Mi" Boiled milk.

Bcat'nwhlteBofe«Bl

ley, and corn). Buttermilk.

Beaten whole esgs.

Vegetable hnHli. Custard.

Bromose.

DIET LIST NO. 12.-

FETEE DIET.

In fever the digestive powers are feeble. With the 1
exception of boiled rice, only liquid food should be j

^H taken.

■ most t

TKKATMENT (.

235

taken. Graels and Bimilar farinaceous preparations are
most suitable, and they should be boiled several lionrs.
A. To be used during the active period of the fever,
while the temperature is high : —

Barlay waWr.

Gmnolii RToal.

Prunes pnrie.

Barli^y gruel.

GluWn BTUel,

Bromose.

Strained tmlmoal gfucl.

Fruit aniJ nnttrruel.

Kumys.1.

Bollod rico.

Un(»Diriit«d a™ lie

KumywHin.

Juice.
Fruit jnlcBs-

Biittpmiilk.

B. During con

valescence, ir

1 addi

ition to the above,-

the following may

bo used : —

MlUi porrldRe.

Whipped Bgg.

Feai'bes.

Cream tonsl.

Kumysa nug.

SlfWi-d froll.

ZwIelHf'k.

Ititked uppli-s.

riifermrntpdbreadu

PoBClu-d PKBS.

'fuustt'd wliolu-wheat.

Costard.

wafrrs.

DIET UST NO. IS.— CNFERHEIfTED BREADS.

Whole-wboat puffs.

Snow Btms.

Buawii blspiilt.

L\>TD puffs.

Wfauie-nlieat aem*.

Kig sandmlL-b.

Unkbam puffs.

Olulen watt^n.

Apple sandwich.

Rolls.

Grabam Hakes. 1

ToasWd rolls.

ToMiwI wafers

Gluten. '

Dyspeptic wufi

Oraiiola. j

BreBkfiKit roll*.

Crisps.

Crusts.

GrahuiD gemN.

Grnbam crlsim.

Zwieback. 1

Ryp Beroa.

Graham <:™<;k*

T9.

StIrkB.

Blueberry gems. TcKLSted beaten biscuit. Hne cukit.

DIET LIST NO. 14.- FOR A BOTTLE-FED INFANT
CNDER (ilX MONTHS OF AGB.

Sterilized cow's milk properly diluted with boiled ]
water, barley water, or oatmeal water. I'ndor throe ,1
months of age, use one third milk ; three to six montfis,
one half milk ; after six months, two thirds milk.

Barlry Water. — Boil one tablespoontul of whole barlej'lo on
enameled sauce-pan or a double boiler for live minutes, and lliri>w
the wat«r awaj ; then add one and one-half pints of water, slowly
almmer down to one idnt, then strain. To be used for dllutinic

986 THB BTOUAOH.

mtllc, orssasubMltute fur it when cow's milk dix'S not Hgree, tuid
in cues of vomiling.

Oatmeal Water, — One tablespoonful of fine o&tmeal, one pint
or boiling water. Boii for one hour, keeping the quantity of in-
ter good ; Bttain. To be used instead of plitin water for diluting '
milk. !

ffarteif WaUr and Cream.— Five parW of barley water mode ij
as directed above, to one part of eterilixed cream,
8ubtUt«ttfoT MothrrS MiUt.—

Milk lox.

CrcHin a OK.

Blcarboimli' of nihIu I gt,

Hilksugiir 3 dr.

Water to m.iki- 8 m,

Orudualty increusi! the quantity of ir.vum and milk as th< •
child lidviinces lii a((i'.

DIET LIST NO. l.l.-FOR \ TEETHISU INTAXT.

As Buoii as a child begiiiH tu cut its tuetb, it flbould-J
begin to u^o tliem. Iti addition to Diet Lint Ko. 14, (
the child may bo fed stewed fruits in Bmutl quantities,
thoHo being avoidwd whit-h require much sugar fcr Hwoct-
eoing. Such fresh fruits as etrawberries, grapes (ex-
cluding the soods and Hkinsj^ ripe poaches, and very rip©
Bweet or subacid apples may bo given, also baked
Bwoet apples and peara. Grauose oaten dry, or granose
and granola eaten with milk or fruit jtiice, are perhaps
the best of all cereal foixls for an infant. Zwieback a
softened with milk or cream, and gluten gruel (Saui-'a
tarium Infant Food) are also excellenr.

DIET UHT NO. ltt.-FnR A (HILO FROM ONK TO
FIVE YEARS OF AUE.

Tlio most suitable foods are those in Diet J
KoB. 1 and 2, which a child from two to five yei
of age may oat without injury, provided, of course, that

TBEATJiIENT OF DYSPEFBIA.

23T

the food is properly masticated. Vegetables sbonld be
avoided until the second teeth begin to make their ap-
pearance, with the exception of the following : Aspam-
gUB, green peas, and baked sweet potatoes. Children
snbject to colic or other forms of indigestion should '
avoid potatoes. Purees of lentils, peas, and beans,
and bean porridge may bo allowed.

The articles included in Diet Lists Nos. 22 and 23
should never enter into the dietai-y of children, being still j
more unwholesome for them thun for adults,

DIET LIST SO. 17.- EATING FOK STBEKOTH.

Those articles are most useful in developing nerv-
ous and muscular energy which are the most easily
digestible, while at the same time possessed of the
highest nutritive value. The nutritive value of the
following articles is, on an average, with the ex-
ception of eggs, about three times that of beefsteak,
while they tax the digestive organs less : Peas, beans,
lentils, whole-grain preparations, bromose, granose,
granola, uufennented bread. The food preparations ,
mentioned in Diet List No. 1 are especially to be com-
mended for producing strength.

DIET LLST SO. IS.- DIET FOB DIABETES.

An exclusive meat diet was formerly recommended
for diabetes, but it is now known that such a dietary
does not give the most satisfactory results, and in-
volves the danger of sudden death from an excessive
accumulation of tissue poisons which the kidneys are
unable to eliminate.

Qlaum biscuit.

Asparsfii-.

KumyFtfl.

Nuts.

LeUuce.

Sntnuri..

Callage cbceii

I- Nul. butter.

Celery.

OmoB.

ButtermUh

^utmeul.

THB 8T01HOB.

DIET LIST SO. in.-FOR RHECMATISM A5D GOCT.

It is especially impoi'tant to avoid an excess of ui- I
trogenous fouU ; hence meats of all kinds must be |
avoided. In cases of dilatation of the stomacb, milk 1
must also be avoided. lu most cases the articles in--]
eluded ia the following diet lists are to be preferred :

DIET LI8T KO. £0.

For gastritis, gastric catarrh, and ulceration of the I
stomach.

LltiDld foods (DIft List

DIET UST NO. 21,

ITnfermentcd gniliuiii Apples

pufHilgc.

FOR (OSSTIPATION.

Curdled ogt

Rieg-nog.

Kuxoyiunu,

Urwked wheat.

Must raw tru1t«.

/.wiebuok.

Grits.

Goflo,

Oatmeal musL.

l-riBlnl wbL-Hl.

rnjHori..

DIET LIST NO.

S2.- ARTICLES DIFHCULT OF DKIENTION* i

ANIMAL FOODS.

Pork.

Scrambled eegs-

Mac^kerclandullollrftidbi

TmI.

Salt bab.

OOMB.

llaslivd and atvwud

lirliidaixd smoked flah.

Urer.

Surdliira auil otber Bsb '

KMncj.

Snltnd BDd Kdokcd

nwiM.

l>HBit«r, crebB, etc. .

SmiiSUBi.-,

Melt«lhutterai.il all

Hard Iwllisl pggs.

VEGETABLE FOODS

Fried mean of all aDrtel

Warm brcnd. cspr-

Oriddle-cBkPB.

Mustard, pepper, splCM,

i^lallr vbeti eutvi

1 Pried bread uud vi-Ku-

wltlihutliT.

l»l>lf«.

Mufflnis.

OlllDBS,

Kiiw gniM ur vegetablM. <

Buttered tonsl.

ItHworlmiHTfectlrcoolM*'

Pies. cak«». mid III

•ort« ot putn'-

Tea. cofft-c. tocoa.

"■'"""■ a

TREATMENT OF DYSPEPSIA.

239

FOODS NOT EASY OF DIGESTION.

The following articles are miicli more digcstiblu than
tliose just named, but are aeverthelesa so difficult of
digestioii that persons with dilated stomachs or weak
digestive powers are compelled to wholly abstain from
their use to avoid inconvenieuce from indigestion ; —

AKIHAL FOODS.

AoltDSilsoupsaf all loHs.

Tripe.

Oodflsb.

Beel.

Tnrkej.

Oysters, raw.

Lamb.

Duck.

Butter.

Game.

VefiETlBLE FOODS.

Roust meata.

Puutoes.

PtUD.9.

Salads of all

Turulps.

CabbngB.

Plneupples.

Tom»toes.

BiKta.

Uoosebprrles.

Pens (wUolo and dried).

Carrols.

Bguus (wbolo and dried).

Splnnch.

Blackberries.

liLulMtrb.

fruits.

Vegetable amp-..

Jellies.

DIET LIST SO. 28.— FOODS WHICH PROMOTE FEBMENTA-
TIOX AND DECOMPOSITION IS THE STOMACH.

These are of three classes : A. Foods which are fer-
menting or decotDpusing when taken into the atomach',
B. Foods which readily undergo fermentation in the
conditions present in the stomach when the digestive
vigor is somewhat impaired ; and C. Foods which fer-
ment in a diluted btouiach.

A. Fermenttns or DecompoBln; Fvods.

B. Fowls which Reodil; I'liilprga FennenlJitlotii

LHIIglll
hy til
ming
furtm

e treat^ I

l^nku, r. & Jl VkKfrnm^grttrnmBmotin die treat-
XM^timt. — Ck-immw tBtmaa^d fareai csl into Uun

tjf^mrnr. — A pnimaboa «f vtwat in vhicb the
gnun ifl finH tl»<r(>o^T cooked, tben compresoed into
ettrvimly thin flakes, wfaidi are afterward baked untU
■lighll;. brown. T».i« f.joj can be eaten and digeatt
inBiiy |M-rBMnii wlio can digest nothing else.

•fft. — A |rreparati<iii of wheat, cx)rn, aod o
Wlnglud in midi |.roiM.rtion« nii to rondt-r tlio mixtorsj
piir/aul tuuii, uial trvatod Id mteh a uiauu«r aa to i

TREATMENT OF DTBPKPBIA.

241

digest it. This food ia capable of snstaming life atij
longtb of time.

Gluten Biscuit. — A small biscnit made of wheat
flonr from ■wliicli the starcb has been carefully sepa-
rated by washing. From this biscuit, carefully dried
and browned, gluten meal is produced.

fiirflmt^CertW.— A substitute for coffee, having a
pleasant, aromatic flavor, and freo from the anwhole-
Bome properties of tea and coffee.

Bromme. — -This is a preparation having for its basis
carefully selected and prepared nutn. It contains about
forty per cent, of digested starch, twenty-four per cent,
of digested fats, and twenty j)er cent, uf finely divided
albuminoids. It is one of the most valuable uf all the
fat- and blood-making foods.

Ifut Mi'ul and Nut Butter. — These are nut prod-
ucts of a very palatable, wholesome, and highly digest-
ible character, and valuable stibstitutes for animal fats.

Gofio. — This is a preparation of parched grain much
employed by the natives of the Canary Islands. After
being parched, the grain is ground, and mixed with
milk or water.

Kvmysii'm. — This is a lactated preparation "f milk
prepared by fii-st sterilizing the milk, and then subject-
ing it to the action of a special lactic acid by which is
produced a ferment whereby the BUgar of milk contained
in it is converted into lactic acid. It is a very easily
digestible and highly nourishing article of food, and is
of great service in certain forms of indigestion, as well
as in diabetes and general malnutrition. Ordinary ku-
myss and buttermilk, though somewhat inferior, are
useful subatitutea.

THE BTOHAOE.

^K eae<

When kumyzoon is made the solo article of diet, it
Bhoulil be taktiii in quantitioB of two to three quarM—
daily and at intervals of four or five hours diirin^l
the day.

Flesh Food. — It will be noticed that meats of all
kinds arc omitted from these liets. The reason for this
is that fleeh foods require strong digestive powers to
disinfect and digest them, since they are not naturally
adapted to the human stomach ; hence, while they are
apparently well tolerated by persons in health, a person
whoso stomach is in a diseased condition will do better
to adhere as closely as possible to the natural diet orig-
inally intended by the Creator for tlie sustenance of hu-
mau beings, as indicated by the command to Adam : " I
have given you every herb bearing seed, whielt is npoa
the face of all the earth, and every tree, in the which
is the fruit of a tree yielding seed ; to yon it shall be
for meat." According to tlie most eminent compara- ,
tive anatomists, the anatomical structure and digestivd j
functions of man agree entirely with those of sucbJ
purely frugivorous animals as the chimpanzee, tho|
orang-ouiang. and the gorilla.

Antisepsis of tlie Mouth. — So long as the ^
mouth is swarming with microbes, which is always the
case when the tongue is coated, and the teeth uncleanly
and presenting unfilled cavities, thousands of germs are
carried down into the stomach with every mouthful *
footi or drink swaUowed. The first step toward i
sis of the stomach, and a most essential thing in 1
treatraent of indigestion, is mouth cleiinliness.

Modern researches have shoKti that nearly all die- 1
eases of the mouth, as well as a large share "f the dis-

TBIATltSMT Ot DfBPXPfilA.

eases of the stomach, are due to the action of germs
which iiDd lodgment there. The mouth is peculiarly
exjwaed to the attacks of j^erms, ae it is located at the
very entrance of the body, and a portion, at least, of the
respired air passes tlirough it, and the germs readily
find lodgment about the tongue, cheeks, between the
teeth, and elsewhere. The nmcua secreted by the
glands uf the mucous membrane lining tlie mouth, is, to
scmie degree, antiseptic in character, and possesses
gtirmicidal, or germ -destroying, properties to some ex-
tent. When the mouth ia kept clean, this disinfecting
mucus is capable of thoroughly protecting the struc-
tures of this portion of the body against the attacks of
microbes ; but when particles of food are left to lodge
between the teeth, the germs, finding abundant soil in
wliich to grow and multiply, Ijecomo so numerous that
the poisonous substances which tbey produce neutral-
ize the antiseptic mucus so that it becomes powerless
for protection.

Meat, more than all other foods, is injurious in this
respect, for the reason that its fibers readily lodge be-
tween the teeth, and are not easily removed, and for
the further reason that it furnishes a kind of soil in
which germs grow with, the greatest rapidity and de-
velop the most virulent properties.

It is thus apparent tliat thorough cleanliness of the
teeth and mouth is one of the most important hygienic
measures. Tliis fact becomes still more apparent when
we remember that the act of eating or drinking and the
frequently repeated act of swallowing to clear the throat
from mucns, a practice which cannot be too much dep-
recated, are the means of carrying down int<] the atom-

S44

THE STOMAOa.

ach any microbeB which ma.y be present in the month.
There are certain microbes, alan, which seem to have
their habitat in the mouth, particularly those of diph-
theria, pneumonia, and conanmption. It is not know&J
that these germs propagate outside the Immau bodyjl
except under artiiicial conditions ; but they find readya
lodgment in tho mouth, and are often present there ia3
persons apparently enjoying perfect health, waiting t
opportunity when a severe cold or some other depreae
ing agent shall, by reducing the resistance of the body^J
enable them to obtain a stronger foothold, and to maoir'J
fest their presence by the characteristic symptoms <
diphtheria, pneumonia, or some form of tubercuU
disease.

A very excellent means of cleansing the teeth is t
Antiseptic Dentifrice prepared by the Modern Medicin
Company, Battle Creek, Mich. Tho basis of this prep*
aration is the extract of the bark of the famous eoap<
tree of South America, one of the most rcmarkaU
cleansing agents known. The antiseptic properties <
the dentifrice are due to the pure cinnamon oil which ll
added. These substances are combined with very t
precipitated chalk, making a detergent paste which i
most effective in its cleansing action. Directions for i
the use of the dentifrice accompany each package. \
Simply rinsing the mouth with cinnamon water, pre- \
pared by a<lding half a teaspoonful of cinnamon €
to half a glassful of water, is a useful means of disin-
fecting the mouth, to be used after thorough cleansing
with a tooth-brush.

Artificial teeth must receive as scrupulous care aa
tlie natural teeth. It is cunaidered best that they sbonlil

TREATMENT OF DYSPEPSIA.

245

be removed nt DJght. After tliorough eleanBing they
sliould be pkcod in a propar receptacle containiug a
quantity of pure water. This will prevent deposit from
insects and the development of fungi, which often grow
with great rapidity, especially in warm seasons of the
year.

The distinguishing features of the several forms of
dyspepsia and the general lino of regimen and treat-
ment necesBarj to effect a cure, are pointed out Willi
greater definitenesB than heretofore in this work in the
following classification, which is based upon symptoms
rather than upon the examination of the stomach fluid,
which is the more scientific method, and the one habitu-
ally employed in the treatment of patients at the Battle
Creek Sanitarium (see page 134). The suggestions
made, if thoroughly understixid and efficiently applied,
cannot fail to be of great service, although based only 1
upon aymptiims. Those who can do so should by all I
means avail themselves of the advantages of treatment 4
at a sanitarium where treatment is ba«ed on the exami-
nation of the stomach fluid.

Simple Dyspepsia. — This, the eimplest audi
most common form of the malady, is sometimes called
slow digestion. It is common in both men and women,
and especially affects sedentary people and those nerv-
ous persons who eat rapidly and swallow their food
without proper mastication. It is also common in
persons whoso teeth 'are defective. Its immediate
cause is delicient activity of tlie muscular walls of tljo ,
stomach and intCBtines. The symptoms are much the I
same as tliose which follow the taking of an excess of 1
food, but are felt even when ouly u moderate amount

■nn

TM PlVUACn.

tiM Iwwii Iwludi. An lionr or two tdter c«tiii^ m sena*>
I I'M) lit wulfflil MNd opprtiMion is felt. Tbe dicoomfun
''ilillriutin for ffftoe bourit. ^nuluallj wi«riDg off before
tlt» iit'Nl (itfiil. Tlid iip]MfUU- is uaoallf foirij good,
liit( cfli'ii ia mil ruiuly for tin* rvcv]ttioa of f'xtd ai tnenl-
lliijK, UN tlii> Work of ili^Htiu); the jireritMis mi-al has
mil ,yi<t l>tit>ii ci(iiij|j|ct«il. Homutiiiic-H there is considvr-
iililii lliihili'iini iif till' HtoriiHch, the cnictntious being
Inoli'lt'Hii, (I lilt ii«vi>r iifri'imivo ; pain iK'twueti the
ithiiiilihii'H iir liKtii-iilli iirin nhoiildcr-bhiiji!, and tiot iti-
fr<i((llt'iill,V 111 ill" ifgUiw iif tho heart. Palpitation of
lllii hititrl. iiri»ii iii'iiiii'K [n till' night, uuiHing great alarm
oil llio |iiirl of lliK piilicMt nntl hix friends, who c-ntertain
tvnvu ut itiidili'i) ih'Uth. Sk>f<ji is Uiatui-hed anil unre-
ftiw)ilii|t, Till' toiiKiit' is friHjiu'iillv foni in tho morn-
Inn, with tt Imd tftoU' in thi> inimth. All tlic symptoms
iitimMithttl HIV HMVrtiiv *'Xtifqp>rHtwt by u late supper, or
li,r Hii.v iinimHit) vmx^kh in ijuantity or ')iuli[y of ft>ocl.
TIlP (mwi-lp HIV Mpl lo Ih« (xmBtiiHiti'^). When tlic diffi-
(Hkll^V ttiia iwvu \\t Umft olAwUnit. ttH'n- is usually oh-
m^rvwl H luMrktHl diii)NwlioH to tdwp after meaU, or

Utilttthlltl) »W)kiltt>M> At t«<lKT til»0&, UhI « dvdtlMl lOM

KvMttiHMttvM t^ tKt> stv^nHkdi tni in tbcs» emoeia
t» )t^>tvr iH i^Mit^T. tVw^ M WW Hy ann or kes dc-

Mwi4, fjtvv twr «w> iW jpNkMvl ijwmiiiiMi alnftlf *•-
{WtlMWWt.. — 1W MRoMAmw Ik «&•» li^pwnJM C'E

TBEATHRKT OV DTBPKPeiA.

especially of the organs cuncorned in tlio digestive
process, and supprosBion, ao far as possible, of tli«
action of germs in tlie stomach aud bowels. The ;
following measures faithfully followed will be found
serviceablo : • —

1. Eut simple, dry food, taking pains to masticate
it very thoroughly. Granoae, zwieback, rolls, and
other nnfermented breads constitute the staple arti-
cles of diet. To these may be added cooked fruits.
The only raw fruits which may bo eaten, in most
cases, are perfectly fresh and well-ripened peaches,
grapes, and strawberries. Very ripe swoet apples are
well tolerated by most patients, if eaten with dry food
and carefully masticated. Nuts, well masticated, are
not objectionable. Milk is tolerated in some cases,
but is better avoided by most patients, unless taken
in the form of kumyss, kumyzoon, buttermilk, or
cottage cheese. Sweets of all kinds must be carefully
avoided, also drinking at meals, iced foods, rich pit^s,
jiastry, rich gravies, pickles, condiments, and all foods
difficult of digestion.

S. The cool morning sponge bath (1), a warm bath
once or twice a week (2, 10, 17), followed by a cool
shower (4) or sponge bath, general applications of
electricity (66, 68), when possible, dry rubbing with a
Uesh-brush or towel at night before i-etiring, a salt glow
(3) two or three times a week, are tbe moat seiTiceable
measures which can be employed at home. A bot bag
may be applied over tbe stomach for lialf an hour after
each meal, to hasten the digestive process. Gentle ex-
ercise or kneading of tbe stomach (31) after eating
also hastens the digestive process. The moist abdom-

5+f?

THfi ftTOMAOH.

iiial baudage (9) at night encourages intestiaal activity,
promotes seci'etion, and relieves congestion of the vie-
cora. A dry flannel bandage worn about the abdomen
during the daytime i» also helpful, eapecially in cold
wosther. Regularity of the bowels must be secured,
by the enema, if necessary, and by other moasm^s recom-
mended for the relief of constipatiou. Electricity
applied to the spine and over the stomach is also a
Btimulaut to the digestive processes, and useful to re-
lieve constipation. The hot and cold full bath (31}J
is an excellent means of arousing activity of the secret^
ing organs connected with digestion.

Swedish movements (39, 4-2)) both manual imd
mechanical, are very helpful.

Some ton years ago the writer devised a vibrating
chair which has been found very helpful in this class ,
of cases, also a kneading apparatus by which the stoni- ^
ach and bowels may be kneaded in a most efficient man- J
tier. This, together with numerous other machines loTM
applying movements to the body which have been de- M
vised by the author, are used in the Swedish movement
department of Uio Battle Creek Sanitarium. The can-
non-ball (Fig. 2, Plate VIIl) is also helpful in stimn-
lating the activity of the intestines, particularly as s
means of relieving constipation,

3. Abundance of outdoor exercise is indispensable
in the treatment of tliis aa well as all other forms of
indigestion. It not only creates a demand for food,
but increases tlie ability to digest it. Horseback rid-
ing, bicycle riding, and boating are all excellent moans I
of exercise, but are perhaps not preferable to useful a
labor in the cultivatiou of the soil.

TREATMENT OF DYSPEPSIA.

2i9

A course of ' ' General Touic Treatiucut '" (page 333)
19 required. In very feeble patients a course of nutri-
tive treatment (page 331) should be given at first as a
preparation for the more vigorous tonic measures.

In this, as well as in all other forms of indigestion
in which germs play an active part, some intestiual an-
tiseptic, one of the best of which ia antiseptic char-
coal tablets (49), is found to be almost indispensable.
Two or three tablets should be taken after each meal,
and continued for several months.

Acid Dyspepsia. — This form of indigestion is
that in which the digestion is so slow that tho food
undergoes fermentation, forming acids which ii'ritate
the stomach, and givo rise to the same symptoms, much
exaggerated, which are mentioned as pertaining to
simple dyepepsia, with several additional ones, the
principal of which are heartburn, regurgitation of in-
tensely Bour liquid from the stomach, and acid eruc-
tations ; a white tongue, frequently with transverse
fisBures, often flabby and indented at the edges ; acid
saliva, causing decay of the teetli ; irregular bowels,
either constipated or unnaturally loose ; grinding of the
teeth at night ; and a reddish sediment in the urine.
There is quite likely also to be pain at the pit of the
stomach, with soreness on pressure. The digestion be-
ing very slow, portions of fermenting food remain in
the stomach from one meal to anotlier, so tlmt acidity
becomes habitual. No one case presents all of those
symptoms, but several are often present.

Patients suffering with this form of dyspepsia are
usually very thin and bloodless. Occasionally, how-
ever, a case of the opposite kind is met, in which

fltar^T foods, tf^wctal]/
alio &«i^ aggrrnnOB the
tendcnry to addit7.

7nw/awW. — Id t^Mn caws, pstieiitd «e fretjuentlv
foond mhMKing al«KHt vhoOy m a meat did, f«ir the*
reacra thm ibr; Snd florii food Ims lUcdr to f<inii
add* liiaii an- Offcal* and Tt^etaUe foods. Tlib prac-
tice, bowerer, aggniTatm the disease in tlie t-nd. sirI
n«vor effects a (-nrc. The meaenres suggested for tlic
relief of «iii|ile dv^pepsiA are equally appntpriale for
this condition. Id adflition, it is neecssarjr in suiii^
ciuctt — in nil ca«?«. in fart, in which Uie tendency ro
acidity is very pronounct-d — to cleanse tlie stomiich at
loiut two or llirce tiitiee a week, and Hcmietimea daily,
by meann of tlie «toHmch-tnbe(46j. The best time for
iva«hiiig thv etuinacli is at night. The- extremi! ulow-
llBBH of the digestive work renders more than two meals
a dfty impossible wilhoat injury. Tlie interval l>e-
tweeii tlio two meals should bo at least seven hours,
riiIdnh tlie quantity of food taken is very small, in
which case it may be as short as fonr or five hours,
and tliu number of uienls may be increased. The
lungur interval, however, is (jrefemble. Milk, un-
feniu-nted broad, sugar, uncooked fruits, very acid
fruits, fruits and vt^getables Together, and coarse v^e-
tabli'M should be cspi-ciiUly avoided, also all articles dif-
Ueull •>{ digestion, and liki.>ly to cause fermentation (Diet
l.ialn Noti. •2'i, :iS), Wheat charcoal in its ordinary

TKEATMENT OF DT8PEP8IA.

251

form, or better in the form of autiseptic charcoal tablets
(49), is almost Indispensable in the treatment of this
condition.

Acourseof " General Tonic Treatment " (page 333),
preceded in feeble eases with nutritive treatment (page
331), is indicated in these cases.

Bilious or Foul Dyspepsia, or Septic Indi-
gestion. — The term bUlmi-H is used to diatiiigiiish
tliis form of indigestion, not because either the liver or
the bile iu the immediate cause, but becauHe of tlie bil-
ious vijuiiliug and sallow appearance of tliti akin whicli
usually a«'campanie8 this condition. Tliis is what is
generally known as " biliousiiesa. " Acute dyspepsia
of the same natnre is termed "a hilioiia attack.**
Women, tailors, shoemakers, and sedentai'y persons
generally, are particnlarly subject to this fomi of the
disease.

As in acid dyspepsia, this form of indigestion ditfers
from simple dyspepsia chiefly in the exaggeration of
tlie morbid conditions present in that furni of the dis-
ease. Digestion being still slower than in acid dys-
pepsia, the characteristic symptoms occur more remotely
from the time of eating. The usual time for the ap-
pearance of the most marked s^Tiiptoms is in the morn-
ing before breakfast. Headache, great flatulence, a
very foul tongue, a bitter taste in the mouth, with
nausea and finally vomiting of undigested and partially
decayed food, indicate tlie inactivity of the digestive
organs. When vomiting is continued, bile is generally
expelled, the duodenum being affected, and taking part
in the expulsive action. Diarrhea often accompanies
ai]<l in some cases takes the place of the vomiting.

252

THE (rrOMACH.

Owing to tiiis thorough clearing out of the rtotnach
and bowels, these attacks nsaally occnr at intervals of
at least several days. They are often periodical, how-
ever, recnrriiig sometimes as often as once or twice a
week, and again not oftencr than once in two to four
weeks.

In addition to the more important ajmptonis meo-
tioned may l>c noted headache, often of a "splitting"
or throbbing character, fetid eructations, and nsoally
severe pain in the eyce.

Farinaceous foods give mnch lesa trouble than meats,
especially fat meats. Vegetables eaten with fat, pas-
try, milk, meat which has been kept too long, and
sometimes eggs, especially those not perfectly fresh,
with albuminoiiB and fatty foods generally, increase the
ByraptfJins peculiar to bilious dyspepsia, and bring on
the attacks. In some cases the disease seems to be dne
t« inability to digest starchy foods. This is especially
true as regards the starch of vegetables. Sufferers from
this difliculty often mako themselves worse by the use
of purgative niodicines.

Treiitiiumt. — Employ the same measures recom-
mended for simple dyspepsia and acid dyspepsia, taking
care to give even greater attention to intestinal asepsis.
Uwe an aseptic diet (Diet List No. 1). It may bo nec-
essary to resort to an exclusive kumyzoon or buttermilk
diet (Diet List No. 25) for a short time. A diet con-
sisting of granose (Diet List No. 25), with fruit-, with
or without the addition of unt meal, is an admirable
dietary to bo followed for a week or two in bilious dya-
pepsiii. GranfjJa, and nmat oilier cfreil foods, if prop-
erly cixikod, agree well wicii tliis class of cases. As

TKKATMKST OK DVfiPKPBIA.

severe constipation UHiially exists, special uttentiou mnst
be given to tUe ruUef nf this condition (see page 279J.

Lavage (46) one to three times weekly is necessary
in the majority of cases of bilious dyspepsia. Charcoal
or antiseptic charcoal tablets (47, 48, 49) should be
taken after each meal. A diet of granose or zwieback,
bromoso (Diet List No. 25), and stewed fruit, will, in
most cases, clfvc-t a radical change within a few days
in cases of thi.s kind.

Painful Dyspepsia. — The chief characteristic
of this disciLse is tL'nderness at the pit of the stomach,
QBualty jiist at the lower end of the sternum, but some-
times affecting other portions of the stomach aiid also \
die duo<loiiuin, the pain in the latter region being oftea
mistaken for some affection of the Uver. In occasional
cases the sensibility extends to other parts of the small I
intestine,

The tenderness described is almost always accom
panied by a very unpleasant sensation at the epigaa-
triitm or extending along under the sternum, describe^l
bytho patient as a "tearing,'' "burning," "rasping,"
''gnawing " pain, which comes on soim aftor taking
food. This pain may bo due to a morbid sensibility of
the mncouB membrane, or to a congested state usually
called chronic inflammation of the stomach, or chronic I
gastritis, accompanied by a catarrhal secretion resem-
bling that from any other mucous membrane in a like
condition. When the pain is due to morbid sensibility
of tlic stomach, it usually ceases when digestion is com-
pleted. Wlien due to congestion, it is continuous, and
is sometimes relieved to a dogreo by taking a moderate
amount of bland food whea tbs stomach becomes

THB STOMACH.

empty. Tlie pain is fiften accompanied by throbbing
of tho aorta, felt at tlie pit of the stomach or below< •
Soxiial excesses are a very conunou cause of irritabili^ ' J
of tho stomach iu both sexes.

Not infrequently the cougestiou to which this pain
is sometimes duo is caused by compression of the ab-
dominal organs, obstructing free circulation. Hence
women who wear coraets aro very liable to be affected
by it, though they will rarely admit the cause, and
still nioro rarely can bo induced to remove it. As a
pithy writer oneo wild, women have a strong "won't,"
whicli they Bometimcs ojipnsu to all arguments, no mat-
ter how irresistible may be the logic.

Trnitmeiit.- — In this condition it is often advan-
tageous to place the patient upon a diet of kumyzoon
for a few weeks, adding eggs and soniu simple farina-
ceotis preparations, suchasgrauolaorglntenujush (Diet
List No. 25). The general measures employed may be
the same as those for simple and acid dyspepsia. A
hot trunk jjack (7) usually gives relief from pain in tho
region of tho stomach, abdomen, and spine.

Frequent eating, which is so often resorted to as B
means of relieving the discomfort experienced in this
form of dyspepsia, is a most pernicious practise, and
serves only to aggravate ttio disease in the end. If
eating ia followed by pain, it may be necessary to con-
tine the diet to the very blandest articles of food, snch
as gluten mush or gruel, gninola mush, buttermilk, and
pnnjes of fruit, peas, or other legumes. Diet List No.
7 is especially euitahle.

In some coses it is preferable for a lime to give tho
patient a small quantity of frmd three or four tic

TREATMENT OF DY8PE1>6IA.

day, thtia a larger amotiiit twice a day, as the stomach
is thus not ao severely taxed as by two bearty meals.
When food is administered more than twice daily,
care should be taken to give only the most easily di-
gestible food. The two principal meals should be taken
as far apart as possible, and the intermediate meals
should consist only of liquid foods. We have found
the hours of $ a, m. and 3 p. m. the most suitable for
the principal meaU, and 13 m, and 7 v. u. for the
minor meals, Not infrequently the appetite is unnat-
ural, the exercise of much will-power being required to
control it. In many cases the pain occasioned by tak-
ing food maybe relieved by tlie administration of twenty
to thirty grains of stihiiitratc of bismuth before each
meal. The remedy is a harmless one, but colors the
stoola hlatrk, front the action of the sulphide of hydro-
gen of the feces irpon the bismnth.

Such articles as cracked and crushed wheat, oatmeal,
graliam bread, and othi-r foods containing the coarser
parts of the grain, are likely to do harm in this form of
dyspepsia, the woody outside parts of the grain acting as
a mechanical irritant to the sensitive mucous membrane
of the stomach. It is this fact which has given seeming
occasion for an ignorant cliiss of writers to declaim so
loudly against the use of whole-wheat floor. The fact
that tlio coarser parts of the grain can with advantage
be removed for certain cases, is no evidence against its
wholesoraeness or ita utility in most otlier cases of in-
digestion. Granose is a most suitable food.

In severe cases, it is often necessary to put the
patient on an extremely simple diet. As a usual thing,
nothing answers the indications so well as milk. It
17

THK BTOHAOH.

should be tukcn as fresh as possible, and about as
warm as can be bornu with comfort, unices there is
considerable fever, when it may be taken in small
quautities iced. Id extreme cases, the irritability may
be so great that the food will be rejected if received in
any but small quantities. If necessary, so small &n
amount as one or two spoonfuls may be given once an
hour at first, both the quantity and the inten-als being
gradually increased until the necessary amount is taken
at the usual intervals of meals. Thou a little well-
boiled and strained oatmeal or graham gruel may be
added, the quantity being increased until the ]iatient
can bear semi-solid food. Many lives have biseii saved
by this plan when death soomed imminent because of the
inability to digest Bufflcieiit nourishment. Sometimes
even milk is found intolerable ; in such cases the most
successful results are often obtained by the use of the
white of egg beaten to a froth, and made palatable by
the addition of a few drops of lemon or other-fruit juice.

In this form of dyspepsia, the patient is apt to feel
a terrible faintncss as soon as tho stomach becomes
empty. This is in some degree relieved by taking
food, which often leads the patient to resort to frequent
eating when there is no requirement for so doing, and
the result is only detrimental. The methods of reliev-
ing many painful symptoms which occur in connection
with this disease have already been described in this
work (see page 155).

In fet'ble patients, nutritive treatment, and in more
vigorous cases nutritive treatment followed by tonie
treatment (pages 3)11 and 3:13), should be employed.
The application of galvanism (69) to the apii^e and :ibdQ>

TRSATKKNT OV DTBPBMIA.

257

men ia an excellent raeane of relieving the irritation of
the abdominal sympathetic nerve, to which ino8t of
the Byraptoms are directly or indirectly traceable. The
treatment indicated for hyperpepsia is necessary in
many cases of painful dyspepsia.

Gastric Neurasthenia, or Nervous Dys.
pepsia. — The sympathy between the stomach and the
brain is very marked. Disease of the stomach may be
produced by mental disorders, and on the other hand,
various mental and nervous affections may arise trom
disease of the stomach. Indeed, c^es sometimes occur
in which the most prominent ejTnptoma of dyspepsia.
by which alone the disease may be recognized, mani-
fest themselves through the nervous system. All the
symptoms previously enumerated under the bead of
mental and nerrone diatorbances are obserred in these

The stomach symptoms of indigestion are sometimes
BO slight as not to be easily distinguished ; yet there is
undoubtedly a serious fault in the elaboration of the
food. The process of digestion is left incomplete, and
the blood becomes full of crude, uoassimilated material,
which not only does not impart to the tissues new life
and vigor, but is a direct source of irritation and poi-
soning. The brain, being the most sensitive part of the
nervous system, of course suffers most ; and hence there
is abundant cause for the mental depression, unbalanced
mental action, confusion of ideas, vacillation of judg-
ment, perversity of disposition, and other kindred dis-
turbances from which the nervous dyspeptic suffers.

Many persons, finding themselves in this wretched
state, and not realizing the influence of physical condi-

Ifl58

THB BTOUAOa.

: tit'iis ii|i<)n tlie luiud, fall into hopeless despair, even

' wlitn no intentionally wrong act has been committed.

' At first thore ta observed simply an exaggeratiou of
real diOiciilties or misfortnnoa ; but after a time the in-
dividual nettles into n utate of gloom, despondency, and
mental depression, in which ho suffers with troubles that
are purely imaginary.

Nervous dyspeptics often suffer much in mind from
a morbid sensitiveness. They iumgine tliomselvea the
subjects of criticism or ridicule, and therefore become
morose, irritable, and exceedingly unhappy. Occasion-
ally they tind theinsolves haunted with evil thonghta,
and sometimes with almost irresistible impnlaes to com-
mit improper or criminal acts, as blasphemy, aaioide.

They are almost certain to imagine themselves -
suffering from many different diseases, usually of an

. incurable nature.

It ia observed that mental disorders uf the chamctor

[' described are often the result of intestinal dyspepaia, a

I'form of the disease in which the local symptoms are

I less prominent than those which relate to tlie stomach,

I but equally grave.

This class of patients are often greatly injured by
the use of mineral waters, whicli, not being absorbed

I readily, remain long in the stomach, and servo to iQ-
ease the nervous irritability.
In nervous dysg^^psia the symptoms characteristic of

I the disease are due to an overexcited or irritated state
of the sympathetic nerves. This is usually the result of
dilatation or prolapse of the stomach, and is the direct
consequence either of the strain upon the abdominal
sympathetic nerves from the weight of the prolapsed

TBKaTMENT of DTfil-EPSlA. 259

stomach, or colon, oi- other abdominal organs, or of the
abaorption of tbo irritating pnxlucts of tlie fernienta-
tioD and decomposition taking place in tlie stomach,
through its inability to unload its contents into the in-
testine witli sufficient promptness.

TriMtiiieiit. — In the treatment of gastric nourae-
thenia, or nervous dyspepsia, the services of a skilled
physician are usually rotjnired. Many patients suf-
fering from this disorder need a change of scone and
Burroundingg, and relief from the home cares and
bnsiness worries which have beeu largely responsible
for the production of the disease. Hence they cau
be more successfully treated in a sanitarium tliau
at home ; and even in a well-equipped institution,
the iugcnuity and skill of the physician are often
taxed to the utmost to bring about a successful re-
covery. Not the least difficult task to be accom-
plished is the deliverance of the patient from the
morbid fancies which hauut him and make him in
imagination a prey to almost every ill to which human
flesh iw heu'.

The general measures of treatment are the same
as those recommended for simjile dyspepsia and acid
digestion. A few special measures, however, will
be found of service, particularly the hot and cold
trunk pack (8), and the application of electricity to each
remote parts as the arms, legs, hack, etc, (65, 67).
Headaclie, a symptom of nervous dyspepsia, is often '
relieved by the application of heat to the back of the |
head, a cold compress over the forehead, including
also the eyes in cases in which the distress extends
to these organs. lu some eases an ice-bag to the

26(1

C STOUAOH.

back of the head, and a fomentation (10) to the 1
the head or over the eyes, gives myro immediate
relief. Hot and cold eponging of the spine (18) is a
valuable means for exciting the vaaomntur centers
of the spine. Galvanism of the spine and abdomen
(69) promotes secretion, and relieves congestion of the
viscera. As prolapse of the abdominal viscera ex-
ists in many cases of this class, the Natural Abdom-
inal Supporter plays an important part in treatment (45).
The same mnst be suid of abdominal massage (20)
and manual Swedish movements (40).

Hypopepsia and Apepsia.— It is not easy
to determine the presence or absence of hypopep-
sia or apepsia without a careful examination of the
stomach fluid ; hut when this condition is known
to exist, — and it may bo suspected in all cases of
great debility, especially in those in which there is
dilatation of the stomach and prolapse of the viscera
in persons past middle age, — ■ vigorous stimulating
measures for the development of both muscular and
secretory activity in the stomach niiist be employed.
In these cases special attention must be given to the
application of heat over the stomach, abdominal maa-
sage (29), hot and cold trunk pack (8), and manual
Swedish movements (39, 41). Moderate exercise
directly after eating encourages the secretion of gastrie
juice. Two other measures of treatment which have
not been mentioned should be employed in these cases,
especially when there ia any considerable degree of
tenderness over the region of the stomach : —

1. The hot and cold doncbe over the stomach (20).

2, The hot and cold douche applied to the etomacll

TkEatmkst of dybpepsta,

261

itself througli the stomacb-tubo, or hot aud cold la-
vage (46). This may be emplojed whenever the etom-
at'li ia washed out, if frequent lavage ia necessury,
or the Btomach-tube may be introduced two or three
timea a week for the purpose of applying this vig-
orous Btimulatiiig measure, even if lavage la not
necessary for the removal of fermenting food or
mucus.

The dietetic measures recoiumcuded for sinipli' dys-
pepsia should he employed in hypopepsia wlthont
acidity, and those for acid dyspepsia in hypopepsia
accompanied by fermentation of the food.

What about Pepsin? — The use of pepsin in
cases of so-called atonic dyspepsia, or hypopepsia, is
very general, and many tons of this digestive ferment
borrowed from the stomach of the bog are annually
swallowed by human beings. It is doubtful, however,
whether any benefit whatever is derived from the use of
this Bubetancre. Some years ago Mosao, by experiments
upon a dog, determined that the stomach of a dog of
ordinary size was able to fumisb pepsin enough to di-
gest 70 kilograms, or 15i pounds, of albumin. This
fact was ascertained by passing through the dog's stom-
ach 2000 litres of water, acidulated with hydrochloric
acid, to determine the degree of digestive activity.

More recently, Georges, according to Dobove and
Remond, has demonstrated that the use of pepsin,
papain, and pancreatin, cither with or without hydro-
chloric acid, are valueless to supply a deficiency of pep-
sin formed by the glands in the stomach. My own
observations f xactly agree, in this respect, with those of
the authorities mentioned.

THE STOUACR.

After having eniployeil pepsin for man^ veare, on
the HtrengUi of anthorit;, I long ago abandoned iu
use, together with tliat of otln-r digestive fennent&,
with tha exception of malt, having been utterly uuable I
to see any good results from tlieir nse. What the stom-
ach reqiiirc»«in cases of inactivity of the gastric glands, .
is not a substitute for the normal product of these I
glaudit, but an increase of the activity of the glands.
pGptogons are needed rather than peptones, pcpttmoids,
or pepsins. Proteid substances arc the best of all l>ep- ■

<as. The natural flavors uf foods and the dextrin |
developed by the action of the wilivn ujjon -starch are I
also peptogciis of the highest value. The fact last |
mentioned furnishes anothiT reason fur the use of dry J
food, thus securing thorough, mastication.

One of the very best peptogens is gluten, ^gg^ \
and milk are also peptogenic substances of value, par-
ticularly eggs. The peptogenic power of gluten veas
well shown in a case exaininfd in the Sanitarium Lab- j
oratory of Uygieiie, in which, by adding gluten to tho |
test meal, tho amount of free IlC'l was increased from J
.036 milligrams to . 1:}U milligrums, uud the total acidityj
from .attO to ..'i54.

The popular idea thai pepper, mustard, and similai
Bubstances increase digestive vigor has been found by I
experiment to be erroneous. These substances, like ]
common salt in excest^, increase the flow of uincua j
without increasing the production of pepsin or hydro- I
chloric acid. The production of pepsin and hydrochloric j
itcid can be increaeed only by natural stuuuli, especially ]
by peptogenic food substances. These consist (1) of 1
proteid substances, which ai-e intended to be digested j

B action of pepsin and hydrochloric acid ; ('2) of
dextrin and maltose, the snbBtancea which naturally
precede peptone in the order of production in the di-
gestive process ; and f^i) of food-Havors, which by the
reflex action jircKluced increase the activity of all the
digestive glands as a preparation for the digestive act to
follow.

The only medicinal agents which I have fuund of
any value whatever in the treatment of hy[M.>i>epsia and
apeptiiu, have been antiseptics, such as cereal charcoal
or charcoal in the form of antiseptic charcoal tablets
(49) previonsly describe<l, lactic acid in twenty-drop
doses, and hydrochloric acid in dosea of five to eight
drfjps (51), well diluted, half an honr after eating. The
use of antiseptics is a matter of great importiinco in
these cases, in many of which the continued use of an
antiseptic is necessary, owing to the failure of the stom-
ach to secrete a proper amount i>f hydrochloric acid.
The aDtiseptic charcoal tablets are a remedy which «in
be used for a long time without detriment. Hydro-
chloric acid may sometimes be used for a few weeks
with advantage, but shonld not be depended upon for
a great length of time. The stomach must be trained
to make its own hydrochloric acid in proper quantity ;
otherwise no permanent improvement will be secured.
In liypopopsia and apepsia great care should be taken
to avoid chilling the stomach by very cold foods.

General tonic measures are required (page '6■i'■^). In
very feeble patients, the rest-cure (page SiiEt), may be
first needed for a time, and it is sometimes wise to em-
ploy nutritive treatment (page 331) for a few weeks be-
fore beginning more vigorous tonic measures.

Hyperpcpsia.^TLe Bymptoms presented in this
condition are in many cases i^linust identical with those
of ordinary acid dyspepsia. The condition itself, how-
ever, is very different, the acidity of the stomach flnid
being due to an excessive secretion of hydrochloric acid J
rather than to fermentation. Yet in eomo emua then
is both au excessive formation of hydrochloric acid i
fermentation. This combination produces the moat B^M
gravated of all forms of acid dyspepsia. Tlio acidity o
hyperpepsia differs from that of acid dyspepsia in th<
fact that it usually makes its appearance soon after t
ing, often witliin an hour, and iDcreaaes as long aa t
food remains in the storaact. Not infrequently the p
tient Buffers from headache and other reflex B_>Tnptom
during the entire period occupied hy the digestive proo-B
ess, almost instant relief being experienced as soo
stomach becomes empty. An examination of the stoin
ach fluid by the method explained elsewhere in tliuiS
work (page 134) is necessary to distinguieh with cer^l
tainty between hyperpepsia and ordinary acid dyspepsia-T

Treatment. — The treatment of hyperpepsia is rad?^!
ically different from that required for the relief of acid
dyspepsia. It is necessary that the activity' of the stom-
ach glands should be diminished. This is best accom-
plished by the following means : Rest for one or two
hours after eating ; an aseptic or dry dietary (Diet Lists
Nob. 1 and 2} ; careful avoidance of the use of me^ts,
condiments, and of all arlicles difficult of digestion
(Diet List No. 22j. When fermentation ia present,
which is frequently the case, especially when hyperpep-
sia is accompanied by dilatation of the stomach, articlea
likely to ferment (Diet List No. 23) and preparations

TEEATMKNT of DTSPKFaiA.

265

of milk, with the exception of kumysa, kuiDjzoon, and
buttermilk, must be carefully avoided. A hot or cold
pack (8) before meals, a wet girdle (9) at night, gen-
eral tonic treatment or, in case of feeble persons, tonic
treatment preceded by nutritive treatment (pages 333
and 331)aretbemea8tire3 indicated. The patient should
take abundance of outdoor exercise daily. Swedish
movementa (39, ^■O) may be employed with advantage,
but movements should not be taken within two or three
hours after eating.

In very severe cases it is sometimes necessary to ad-
minister Boda in ten- to twenty-grain doses soon after
eating, to neutralize, in part, the excessively acid gas-
tric juice.

Catarrh of the Stomach.^ This condition is
characterized by the production of an excessive quantity
of mucus in the stomach. Tlie tongue is heavily
coated ; there is loss of appetite, either partial or com-
plete; usually tenderness at the pit of the stomach; con-
stipation; in many cases dilatation '.t prolapse of the
stomach ; and not infrequently occasional attacks of
jaundice, accompanied by severe pain similac to that of
gall-stone, but unlike it, in that it docs not terminate
suddenly, as in the passage of gall-stones. Jaundice
in these cases ie always much more persistent than that
which appears in connection with gall-stones.

Treafr/ii-vf. — In the treatment of catarrh of the
stomach, tlio measures recommended for simple dys-
pepsia and painful dyspepsia should be employed.
An aseptic diet (Diet List No. 1) agrees beet with these
cases. All articles difficult of digestion (Diet List No.
23) and liable to ferment in the stomach (Diet List Ko.

or evvrj otlier daj, tf &e toosae >* ^^cy foal, uid
OHvfcMl wjmfOBta at TnifigFirinii ate ptMeot. " Gen-
eral ToMiic Treatnoit'^ i page 333) afaiMU be giren io
conacctim wid tfas ocW luf ■■■?>■ nggeated. In
umaj caw* aeooMdaaUe ^B antt ^ of water will be re-
^aind to wagfa oat dw moeaa whirfa has aoeamnlated.

Tbe mnwt abdominal bandage (9) and the hot and ,
cold tmnk fnck ^8; aboald be aaBdnoasly i»ed, and fMC: j
a lontf time. Aj^tringent* are of no Taloe. If (XMH- ■
iidersble irriistion exists, ami pain after eating, twenty
or thirty graio-s of aubnitrale of bismath |62^ may be
taken befi>re each meal.

Starch lodigestiun. — Indigestion of starch may
be tlie result of sereral causes ; —

1, ItinnfGcieut ctmking of the food,

2. Insufficient mastication, and consequent insnffi- ,
cioiit inHalivation.

'^. An excCBBively acid gastric jnice,

4. Improper food combinations, as the eating of
vitieKur or »ome strong vegelahle acid, like lemon .
juice, in connection with farinacooua foods.

fi. Thii taking of a lurgo quantity of fluid with the
fof«J, thus dihiling tlic digoative juices to an excesBive
dcgi'<w. Tlio Btiirch of vogotables is much more difficult
iif digt^itioii than that of most grains. Potatoes sscm
to lio iiioro liatilo than otluT vegetables to give rise to
Indigestion iu tlicso cH§es, perhaps frtirn the fact that
thoy contain a larger quantity of potash than otlier vege-

THBATMENT OF DT«l^I^tA,

S67

tables. The jtotash salts are very irritating tu a. aeusi-
tive stoniach.

The syraptnms of starch indigeBtion are flatulence,
distentiDn of the atoimich, in some iiistancea acidity,
- with enictatioiis of gas aitd sour liijuids — in other
words, the symptoms of acid dyspepsia,

Trfntiitfiit. — Tlie treatment consists of tho follow-
ing inoasurea : —

1. Tho removal of each of the causes mentioned,
which have been sufficiently clearly indicated to render
further directions unnecessary.

2. The use of dry and thoroughly sterilized food.
Germs are the active eanae of the indigestion of starch.
Experiments made in the Laboratory of Ilygicno of
tho Battle <_'roek Sanitarium have shown that a tc^t
meal consisting of granose furnishes no germs what-
ever, all tho microbes swallowed with the fimd being
destroyed by the normal gastric juice produced when
a dry and well-sterilized food sneli as grauose is eaten
with thorough mastication.

3. The use of sonte good antiseptic, as antiseptic
charcoal tablets.

4. The employment of f(x>d substances free from
starch, as gluten, malted gluten, and in stmie cases
malted milk, nuts, nut meal, eggs, kurayss or kumy-
zoon, buttermilk, and cottage cheese. A nitrogenous
dietary (Diet List No. 3) or a diet of fruits and nuts
{Diet List No. 10) may be advantageously employed.
Marked benefit is frequently experienced from the use
of a strictly dry diet (Diet List No. 2).

It is particularly important to avoid the use of pots-

I of
bSe 4wia. IiafriM] io-
4t t» gmiaie imli-
HaMj MtiiM'aa, wfanliT food eai
liBBMs mponcuj' aewd^ ■■■ Mler > turn
iMdf dnvB Mte Ab ilnatit, Ane tobecotDeaa
at irriMawt, ii oam of At miMl eoannoa asses t
teatinal indigMtian. Tk me el coedimentB,
qnsndties of nneete, tntmt, conas regetables,
dies, ieeft, etr., are alao ooaunoa caosea of intestinal
d;iipep«ia.

Trmtment, — Well-cooked oereals, cooked fmita of
sll Hnrta, kouiTHS. kamrzoon, or bnttermilk, ^^s, and
Dnt meal ehoald crtnatitnte tbc dietarr in cases of intes-
tinal djHpcfMia. Drinking at m^als should be <
fullj' avoided. Antiseptic charcoal tabtols (%^) or tbejr^
eiltiivalniit are of great service in aidiDg the etomachf
in dcfltmylnK germB, to the action of which the disturb- .
aiice in the lut^Btines is chiefly due. It has
r«'C«iitlj' "li'iwn by careful bacteriological study, thatj

TRBATMENT OF DTBPEP8IA. 269

the intestiites always contain fewer genus than the
stomach ; so that if the contents of the stomach tire
made perfectly sterile, it is reasonable to believe that
the nnmber of germs iu the small intestine may thus be
rapidly diminished.

Fomentations to the abdomen at night (10), followed
by the moist abdominal bandage worn over night (9),
also a cool spongts bath (1) every morning, preceded, if
necessary to avoid chilliness, by fomentations to the
spine and vigorous rubbing with a coarse towel or a
dry flesh-brush, are the most important measures of
treatment wliicU can woU be employed at home. If
there is prolapse of the bowels, the Natural Abdominal
Supporter (45) should be worn. The bowels must be
kept well evacuated, by moans of the enema (22) or
coloclyster (23) administered daily, if necessary. It
should be employed quite hot in cases of looseness of
the bowels and diarrhea, and at a lower temperature
in cases of constipation. If much mucus is present
after the bowels have been thoroughly wushed out by
the coloclyster, a quart of water containing one dram
of tannin may be taken and retained for ten or fifteen
minutes, the remainder then being passed o£F. See
also measures recommended elsewhere for diarrhea.

Torpid Liver. — Errors in diet may justly he
said to be the most frequent of all the canses of torpid-
ity of the liver. Fashionable dinners, late suppers,
overeatiug, and especially the exeessivo nso of fats,
sugar, pastry, condiments, alcoholic drinks, tea and cof-
fee, are the most common causes of inactivity of this
organ. The free use of mustard, ginger, pepper, curry
powder, auU other irritating condiments, leads to tha

270

THE FTOMACH.

almoBt amversal prevalence of this diseaaG id many
tropical countriee. Id addition, sedentary habits, the
use of tobacco and other narcoticB, restriction of the
liver by wearing tight clothing, and also malarial dia-
eases, may be mentioned as freqaent causes of torpidity
of the liver. The prolonged nse of laxative medicines,
"after-dinner pills,"' and the various drugs recom-
mended for eiinstipation are most prolific sources of
torpid liver. The same may bo said of mercnrv, al-
though this drug is less frequently used than formerly.
The liver possesses the curious property of being
able to retain in its structure metallic poisons which
may be brought to it in the circulation, so that the
injury received from a mercurial course is apt to he
more or less permanent.

Treatiiitiit. — In severe chronic cases of this affection ■
the patient must carefully avoid the use of fats, sagBTii
condiments, and alcoholic drinks. Hegulation of t
diet is a positive necessity in the radical treatment (
tills disease. Tobacco, if used, must also be discoB^
tinned. If the patient's habits are sedentary, he mast b
gin a course of regular, systematic exercise, and should
strive in every way possible to build up his general health.
Food should be taken in moderate quantities, and
should consist diiefly of grains, nuts, and fruits. Some
are obliged to av<)id the use of milk, while with others
it does not seem to disagree. In addition to these ,
general measures, the patient, if not emaciated, i
with advantage take two or three vapor baths (16) "
{)aok8 (6) a week for two or tlireo weeks, Tlio wetl
girdle (9) slmuld bo worn night and day. The use of tin
hot and cold douche over the liver (20) is very effic^enC

TBXATUBHT OV DT8PHPSIA.

Central gaivanization may also bo applied with aiJva
tagu. Tho O80 of the various liver medicines which a
recommended for this very common affection will (
more harm than good. The best that any of thesail
drugs can do is to whip np the flagging energiea of thej
already overworked organ, without in any way lightening
its burdone, or giving it increased atreugth to perfon
tlie labor required of it. Tho repeated nse of remtf
dies of this kind greatly aggravates the trouble, aa ]
only increases the inactivity of the organ. Merot
does not stimulate the liver, as is commonly
posed, but, on tho contrary, lessens its activity.

An aseptic dietary ( Diet List No, 1 ) should be
adopted, Kumyzoon or buttermilk should be UJ^ed in
place of milk, and in many cases nut meal (Diet List
No. 25) should be substituted for milk and butter. ^
Fomentations may be applied over tho liver i
with advantage, and a cold sponge bath taken evei
morning.

Vigorous outdoor exerdse is a matter of very grei
importance. Breathing exercises (38) are especially
helpful, as they aiti the circulation of the blood
through the organ, thus diminialiing congestion. So-
called torpidity of the liver is chiefly duo to the forma-
tion of poisonous substances in the stomach. The
liver must be relieved, as far as possible, of all nn-
necessary burdens by tlio discarding of all substancea
which are readily decomjKisablo (Diet List No. 23).
Intestinal antiseptics are of great value. Charcoal or
charcoal tablets (47, 48, 49 ) may be constantly used
with a<lvantage by persona who habitually suffer from
biliousness or torpidity of the liver.
18

27S

TBB STOUAOH.

Infantile Dyspepsia. — The most common symp-
tom of infantile dyspepsia is vomiting. When tiie luat-
tera vomited are very sour, tbe child ia suffering with
acidity of the Btomadi, which may bo the result of over-
eating or of the use of sugar or starchy food. Qreeo,
offensive bowel discharges indicate decomposition of
the contents of the intestines in consequence of imper-
fect digestion. Tbe green discharges are generally pre-
ceded by discharges in which lumps uf card are seen,
indicating that digestion is imperfectly performed.
After awhile, an irritation of the intestinal canal ariat
from the coiituct of hard, undigested curds which shooldfl
have been digested in the st<^>mach, and the discbargwl
become more offensive in character, and are likely to.]
contain considerable mucus from catarrh of the bowolB. J
Clay-colored stools indicate an inactive condition of thfij
liver, or an obstruction of the bile ducts, probably il
consequence of the extension of the intestiuai catar^fl
into the bile dacts. When the stools continue greenish, T
sour, or fetid, the child sometimes shnws marked symjH I
toms of wasting, becoming thin and wrinkled, — thaj
countenance wearing an old look, — weak, peevish,
restleBS. In many cases, the child has convulsions i
consequence of its weakened state, and sometimee diosfl
in one of them. In other cases, it dies from exhaustion, f
When vomiting is the principal symptom, the difHcal^
frequently increases until the little sufferer is unable USM
retain anything upon its stomach.

The chief causes of infantile dyspepsia are, over*
feeding, the nse of unclean bottk-s or of titale or unstei
ilized milk for bottle-fed babies, improper food,

TREATMENT OF 1

278

I
I

errors in diet or ill Iioallb on the part of thv mother
during tbe nufBing period.

Trt-iitmcn!. — The dietary should be adapted to the
age of the child (Diet ListB Nos. U, 15, IC). Dnrilig
thu attack a special dietary will be required. If the
child is six mouths or more old, milk should be with-
held for a few days, thin, well-boiled bark-y or oat-
meal gruel being substituted. The beaten white of eggs
dissolvud in water or a thin gruel is also an vxcollent
diet iu euMOs of this soil. General tonic mcaRures nro
required (pago 33ii), and the other measures rocom-
nicnded for relief of slow digestion (page 245).

An Important Caution.— It is of great im-
portiiuce to reciiilot:t that the special directions for the
diet in dlfforeTit forms of dyspepsiti here given are not
intended as rules to be followed for any great length of
time. In many cases it is necessary to adhere strictly
to the s|>eciul dietary only for a few days, when it may
by degrees be made to iucliido a larger variety of foods.
This fact liiu^t, however, be impressed upon the mind of
the dyspeptic, thut when he tinds himself well again,
he must not make the error of supporting that the prin-
ciple "once iu grace, always in grace " in any BOnBo or
in the smallest degree applies to the improved slato of
his digestion. Although the stomach may be restored
to a sufficient degree of health and vigor to enable it to
do its duty well under favorable circuiuBtauces, it will
be certain to relapse into a discjiscd state again as mooq
as those conditions are no longer supplied. The
dyspeptic must make up his mind to etndy earefiilly the
laws of good digestion, ami upply thoni to hist own case,

THE BTOMAOH.

Dot on]y as s means of recoTering his beuUb, bat as a
taeeDtJR] for keeping well wben be has recovered.
When ttic stomach has once I'jst its natnral, healtbjrl
tone, it will never again bear the degree of abase which*
it luajr have endured for a considerable time b^ore
breaking down.

In the treatment of tiyspepaia, attention to the
principles of Iiygiene and the application vi hygienic
remedies are of first importance. Indeed, it is by these
agents that nature is sided in her restorative work more
than by any others, and npon these the most skilful and
snccessfnl of those who liavo given great attention to the
treatment of the functional diseases of the stomach find J
it safest to rely. Undoubtedly there are cases whicbj
may be benefited, and the work of cure hastened, by J
the employment of medicinal agents ; nevertheless, that I
abuse of drugs is so very great, and has been tito direottl
caase of so many cases of confirmed dyspepsia, that it J
would seem far better to do without them altogetb^
than to use them as they are frequently employed. An J
eminent writer on this subject, in referring to the treat- ■
ment of dyspepsia, says, "My main object in the
treatment is to prevent the sufferers from resorting ■
to drugs, which in snch cases not only produce their j
own morbid conditions, but also confirm those alreadjrj
existing. ' ' *

TIte extensive and often habitnal use of alkalies for
acidity, of purgatives for constipation, nervines and
opiates for sleeplessness, and "after-dinner pills" to
goad into action the lagging stomach, has been a potent J
factor in the production of a large class of most inveter-jj
ata dyspepsias. This sort of treatment for dyapepsi&l
* ChaiDb«r«.

TREATMENT <

375

cannot be too mncli discouraged. Especially to be dis-
countenanced is the wholesale employment of "liver
pills," "stomach tonics," "anti-bilioua pills," "bit-
ters," and the entire genns of qnack nostrnms and
proprietary drugs.

Chronic Catarrh of the Stomach. — The
syniptoraa of chronic gastric catarrh are prc'ssure and
fulness at tho stomach after eating, flatulence, heart-
bum, little or no appetite, vomiting, water-brash, ten-
derness at the pit of tho stomach, slimy tongue, bad
taste in the mouth, obstinate constipation, occasional
jaundice, mental depression, lassitude, pains in the face
and limbs, and sleeplessness.

The chief causes of gustric catarrh are chronic indi-
gestion, tho UBO of flesh food, hasty eating, overeating,
the use of condiments, alcoliolic lic|uors, tea, and cof-
fee — in fact, whatever tends to excite, irritate, or in-
terfere with tlio normal functions of the stomach may
produce chronic gastric catarrh. In this disease there
is an abnormal development of microbes, which, being
imbedded in the mucus which covei-s the lining mem-
brane of the stomach, are retained and attack the food,
giving risQ to fermentation, and the consequent produc-
tion of poisonous substances which increase the gastric
irritation and catarrh, and when absorbed into the sys-
tem, give rise to the great variety of nervous symp-
toms present in this disease.

Treatment. — Proper regulation of the diet is the
most important measure. Coarse foods must be
avoided when there is much local irritation, the diet
beuig restricted to well -disintegrated foods. An asep-
tic diet, and in severe cases a liquid diet — exclud-

276

THE STOMACH.

ing, however, milk (unless in the form of kiimyzoon,
kum^'ss, or buttermilk), beof tea, and meat broths of
every description — must be employed fur a, consid-
erable length of time. Condiments must be avoided,
as well ns all exciting food sabstances, together with
tea and coffee, and alcoholic liquors in every form.
The treatment to be employed is tbo same as that
recommended for "Bilious Dyspepsia" (page 251), a
frequent precursor of this disease. The moist abdomi-
nal bandage (9) worn at night ; the hot and cold
trunk pack daily (8) ; the daily cool morning sponge
balh (1) ; lavage of tllb stomach (46) two or three
times a week, if necessary to remove accumulated mu-
cus or to suppress fermentation ; the giadnated enema
(2^) when constipation exists ; and all measures for
the improvement of the general health whicli have been
mentioned elsewhere in this work, are the most reliable
means of combating this disease.

"General Tonic Treatment" (page 333) should be
employed, beginning with "Nutritive Treatment"' in
the case of feeble patients.

Ulcer of the Stomach. — The symptoms of
nicer of the etoniach are pain in the stomach and in
the Bpino opposite the sturauch, increased by taking
food, especially hot drinks and sugar ; tenderness of
the abdomen, pai-ticularly over the stomach ; violent
beetmg at the pit of the stomach ; vomiting ; ulcerated
and furred tongue ; often great thirst ; coustlpatioa.

tjicer of the stomach is a much more common dis-
ease than is generally supposed. Many coses thoDghl
to be merely neuralgia of the stomach are really chrool
ulcer, the two diseases being very easily confoondeifl

TREATMENT OF DTaPEPSlA.

277

The nicer may be very amfill in size, not more than one
fourth of an inch in diameter, or it may extend until it
becomes b.s large as tho palm of thci hand. Sometimes
the ulcer eucirclea the stomach like a baud.

The chief causes of ulceration of the stomach are
the use of condiments and other exciting foods, the ex-
cessive use of meat, the tiae of alcoholic liquors, oTer-
eating, hasty eating, and hyperpepeia (i>age 204). It
sometimes results from gastric catarrh.

Treatment. — ^In scveiB cascH tho stomach should
be given absolute rest, the patient being kept in bed,
and nourished by nutritive enemata for some days.
After a week or two a liquid diet may bo employed,
tho patient being given only very small quantities of
food at intervals of threo or four hours. The liquid
diet should bo adhered to for aouie weeks, until all the
symptoms have disappeared. Tho severe pain of ul-
ceration may U) greatly relieved by fomentations. In
some instances ten or fifteen grains of soda taken just
before eating aSord relief by decreasing tho acidity of
the gastric jnicc. In cases uf ulceration of tho stomach
in which dilatation exists, the stomach-tube may some-
times bo use<i to advantage (46) when fermentatioo
is present, hut it must be employed with very great care.
Salt sliould bo omitted from tlio Bolutiou used in wash-
ing out the stomach. Tbo measures elsewhere recom-
mended for liypopepsia (page 260) should be employed,
in addition.

Cancer of the Stomach. — The symptoms of
cancer of the stomach are pain at the pit of the stomach
of a burning or gnawing character, increased by food ;
tenderness to pressure over the stomach ; nausea and

278 THE erouAca.

frequently vymtring. tLe vomited matters often resem-
bling coffee grains ; bard, pulsating tnmor felt near the
pit of tLe Btomacli ; great emadotion ; tawn/ yellow
complexion ; symptoms of enlargement of the etomadi ;
great eshaostion ; spelling of the ankles ; sometimes
general dropsy.

Cancer of the stomach is one of the most frequent
forms of malignant disease. Recent researches seem
to show tLat cancer is a parasitic disease. Like other
parasitic maladies, cancer does not attack a healthy
organ, but only one which has become weakened by
abuse. The nse of alcoholic liqnors and chronic indi-
gestion are doubtless predLqrasing canses of cancer.
Tlie disease itself is not hereditary, but tlie predisposi-
tion to it ie. Cancer of the stomach frequently occotb
subeeqaemly to cancer in other organs of the body.

Trenttin-nt. — This disease is practically Incurable^
By careful treatment, however, much can bo done to
prolong the patient's life. The same measures should
be employed as have been recommended for chronic
catarrh of tlie stouiach, ulcer of the stomach, and dila-
tation. Dilatation of tlie stomach occurs in cases of
cancer in which the disease attacks the pyloric portion
of the organ, thns causing obstruction at the outlet of
the stomach. Tlio disease is greatly aggravated by tho
use of meat. An aseptic dietary (L>iet List No. I)
ia always indicated. When a state of ulceration is
reached, the diet must be wholly liquid in character,
and the treatment should bo such as has been elsewhere -4
recommended for "Ulcer of the Stomach" (page 276).j]
" General Nutritive Treatment"' (page 331) should \
employed.

TEESTMEST <

279

Constipation. —The canseB of this exceediagly
common condition aro very numerous. Some of the
most frequeut maybe enumerated as follows; —

1, Prolapse of the bowels, a condition in which
the stomach is usually involved, is the cause of chi'onic
inactivity of the bowels in a very large nnmber of cases,
especially among elderly people. The usual causes of
prolapsed bowels are two : —

(1) Tight-lacing from corset-wearmg or the pressure
of tight bands, in women ; or from wearing belts, a
practise not oncommon among soldiers and cert^n
classes of laborers, in men.

(2) A relaxed condition of the abdominal masclea,
common in both sexes, but most frequent in women, be-
ing the resnlt of improper dress, a sedentary life, or in-
attention to the proper attitudes in sitting, standing, and
walking. When the large intestine becomes prolapsed,
it is not infrequently folded upon itself, producing a
sort of pseudo-stricture, so that the fecal matters, de-
tained in their passage along the intestine, become
hardened, and accumulate.

2, Dilatation of the large intestine is nsually the
result of overaccumulatiou of fecal matters, but la
sometimes caused by abnormal fermentations. This
condition may be the residt of tlio preceding, as the
pressure of vigorous abdominal muscles is necessary to
prevent overaccumulation of gas, and to support the
thin walls of the intestines. It is quite likely, how-
ever, to result from neglect to empty the bowels regu-
larly. When overaccumulation has been allowed to
exint habitually for some months or years, the walls
of the intestines may become so stretched that their

THE 8TOHi.0H.

^^B tlirougl

natural moscnlar activity i» gone, and can never be
recovered, althoHglj aome improvement may be aecnred
by proper treatment. This condition ia common in
both sexes, but is more frequent in women, and is the
direct result of improper dress and sedentary habits.

3. Dilatation of the stomach, a condition exceed-
ingly common in personB suffering from dyspepsia, and
existing in fully one half of all cases of this kind, some-
times becomes a cause of constipation by provoking
intestinal catarrh through the irritating inflnence of
fermented and improperly digested substances, which,
after a long delay, escape from the stomach into the
intestine.

4. General weakness and relaxation of the mus-
cular system of tlic body may induce a similar condi-
tion of the intestinal muscles, resulting in constipation
from deficient peristaltic activity ; hence exhausting
labor or, in fact, anything which exhansts the nerve
centers, may give rise to intestinal sluggishness.

5. A torpid liver, by which is meant a liver^ which
does not secrete a sufficient quantity of bile, may be the
cause of constipation. Bile is a natural laxative, serving
to stimulate the muscular contraction of the intestinal
walls. When lacking in quantity, deficient intestinal
activity is a natural result. Anything which clogs the
liver, or renders it inactive, may be a cause of consti-
pation. The use of animal food, condunents, tea and
coffee, and an excessive amount of sweets and fats,
must all be considered as productive of constipation,
through their intluonco upon the liver.

fi. Hemorrhoids may be a cause of intestinal inac-
tiviQ', acting mechanically to prevent comploto evaoua-

TBEATUENT OF DyBPKFSIA. 281

tion of the bowels, aod to cause a i-etention and harden-
ing of fecal matter. The n amber of peraonB who carry
about with them constantly congiderable quantities of
hardened fecal matters in the large intestine, mast be
very great, judging from the results of treatment in
dislodging old accmnulations of this sort in cases which
have come under the writer's care. In some cases,
great cjuantities of black and decomposing matter have
been discharged after two or throe weeks, during which
time the patient's bowuls had been daily washed out
with two or three quarts of warm water applied in the
most thorough manner possible.

7. Rectal nicer, catarrh of the rectum, and an irri-
table rectum resulting in spasmodic contractions of the
muscles which close the lower end of the bowel, some-
times induce constipation by presenting too great resist-
ance to the expulsive effort by which the feca! matters
are discharged from the body, so tliat the bowel is never
completely emptied, and the accamulations thna began
are gradually increased.

8. A loss of natural sensibility in the mucoos mem-
brane of the rectum is doabtleas a frequent cause of
constipation. This semi-paralyzed condition is usually
due to failure to evacuate the bowels at a regular time.
After long neglect of this sort, the natural reflex
activities by which the boweU are stimulated to ex-
pulsive action are no longer awakened by the pres-
ence of fecal matters in the rectum ; and constipation
is the result.

9. Another cauao of constipation is excessive dry-
ness of the fecal matters, which prevents tlieir ready
movement along the loi'ge iotestiue. This is usually

2S2 T

the result of tuo long retention witbia the lower bowel,
but may result from other causes, aa a feverish condi-
tion, or from a deficient secretinn of tlie maens which
acts na a lubricant.

10. Many persons are finflering from chronic con-
stipation as the result of "oriflcial surgery." The
rectum not only contains pockets in which a qnftutity of
mncus is formed for the purpose of lubricating the fecal
mass as it is expelled from the boily, but a fringe of
papilla is also found in the healthy rectum just within
the anal orifice. These papillio arc connected with
nerves, tlie function of which is to bring forcibly and
involuntarily into action at just the riglit moment tbe
fitrong muscles of the abdominal wallw, so as to accom-
plish complete evacuation of the bowels, Tbese pock-
ets and ])apill8B were discovered by Professor Horner,
the eminent anatomist of Pliiladelphia, who described
and pictured them in his "^^ Anatomical Atlas" nearly
half a century ago. The " orificial " surgeon often iu-
duBtriously trims off every papilla, and slits np every
pocket, for no otber reaaon^ apparently, tban to line his
own pockets, and certaijily to the great disadvantage of
tlie patient, who, with his rectum tlius maimed, has lost
two important links in the chain of automatic activities
by which nature secures o daily evacuation of the
bowels,

Treaimtnd. — Any coarse of treatment, to be cura-
tive of tliis condition, must take into consideration all
the various possible causes which may have brought
about the intestinal inactivity in any particular case.
It is necessary also, not only to remove these causes,
but to repair, so far as possible, by the application of

TKEATMEST OF

efficient means, the damage which has been wrought by
wrong habits and morbid influences.

The matter of first importance in the treatment o£
constipation is the diet. Tlie abundant use of fruit is
one of the most excellent meana of preventing nnd
curing this disease. One or two oranges before break-
fast ; a couple of applea at breakfast ; the free use of
steamed figs, stewed prunes, and other fruits, are means
to be recommended in nearly all cases of chronic con-
stipation. There are, of course, some cases in which
frnits must be avoided. In these cases coarse grains —
cracked wheat, oatmeal, graham or bran breafl, bran
cakes, etc. — serve a useful purpose. Peas, beans,
lentils, asparagus, green peas, string beans, and similar
vegetables which are easy of digestion, but which con-
tain a considerable amount of woody or indigestible
substance, may also be advantageously used. Coarse
vegetables, however, most bo avoided in cases where
there is marked dilatation of the stomach. Granose,
goflo, and other esc-ellent heuUh foods manufactured by
the Battle Creek Sanitarium Health Food Co., Battle
Creek, Mich., have proved of very great value to
thousands of persons suflfering from this condition.
Granose (Diet List No. 25), a new health food recently
perfected, is especially valuable as a food-cnre for con-
stipation, if freely used. Most persons are very promptly
relieved by its use. Bromoso {Diet List No. 25), an-
other now health food, is also found to be a very ex-
cellent remedy in these cases.

A gla.ss of cold water before breakfast is a prescrip-
tion which has cured many cases of constipation. Tlie
free use of water, either hot or cold, taken one or two

THE STOKACB.

hours before each meal, is a valuable remedy. (See
Diet List No. 21.)

Exercises of rarious kinds, particularly such as
bring into active play the mnsclcs of the lower part of
the trunk, are essential in the treatment of matiy cases
of intfHtinal inactivity. Walking throe to five miles 8
day ia sufficient to secure regularity of the boweU in
many persons. A short walk before breakfast is espe-
cially helpful.

The exercises of the Ling system, known as Swedisli
gymnastics, have been found of special value iu the
treatuiout of this class of cases at the Battle C^ek
Sanitarium (^S). Horseback riding, rowiDg, and bi-
cycle riding are also very helpfnl.

Massage of the bowels (2!), 30), Swedish move-
ments (48), tlio wet girdle (9), applications of elec-
tricity to the alxlomen (6t>, 69), and, in special casea,
to the abdomen and rectum, are measures of great ira-
IKirtance. The livor dnncbo (20) and the hot and cold
full bath (21) .may also bo ompluycd. General tonic
measures (page 333) are essential as means of reinforc-
ing the general nervtms energy. In cases t>f prolapse
of the bowels, the abdominal supporter (45) should
liQ worn.

Introduction into the rectum of a small quantity of
cold water, half a pint or a pint, before breakfast, to be
retained until after breakfast, is u useful meusure. A
small, cold enema taken at the regular time for the
bowels to move, is better than a large, warm one, »»
it is a more powerful stimulant to intestinal activity. A
small amount of cold water ijitroduced iTito the rectum at
night upon retiring, is a useful measure in casea where

TREATMENT OF DYSPEPSIA.

285

DO inteBtinal contents are dry and hard ; half a pint or
a pint 18 a aiifficieiit amount. In some cases in which
the stools are large and the rectum irritable, an ounce
or two of olive or almond oil introduced at night or
before breakfast is a useful measure. Camphor water,
eoneistiiig of three or four ounces of water to half a
teaspoonful of spirits of camphor, may be introduced
into the rectum before breakfast with advantage in
many cases. Some cases are relieved by the inti'oduc-
tion of a small quantity of glycerin, — two or three
tablespoonfuls with an equal quantity of water, — al-
though Bometimes pure glycerin may be necessary.
Two or three trials will determine. Sappositories made
of glycerin or glycerin and camphor are also valuable
for the same purpose ; tliey may be introduced either
at night or before breakfast, or at both times.

When the rectum is the scat of catarrh, a mixture
consisting of equal parts of starch and boi'acic acid,
introduced by meaus of a proper instrument, is a very
helpful measure. The nso of equal parts of boracic
acid and eubcarbonato of bismuth, or swbcarbonate of
bismuth alone, is preferable when thi-io is an unusual
degree of irritalion. The introduction of a dram or
two of boracic acid into the rectum daily before break-
fast, is a most valuable remedy, and one which is often
found curative of this condition.

It must not be forgotten that regularity in attending
to the demands of nature is a matter of the utmost con-
sequence in these cases, both as a preventive and a
curative measure. Sometimes the inability to evacuate
the bowels is due to weakness of the abdominal mus-
cles ; in such cases it may bo necessary to aid the bowels

286 T

by preasnre of the hands. Several cases have come
andcr tlie author's care in which there wua inabilitjr to
evacnate tlio bowels when sitting in the usual position,
but no difficulty when a crouching position was as-
BUiuod. This was doubtless due to the increased pres-
sure brought to boar upon the abdominal contents when
sitting in a eronched position.

Some cases of constipation tax the skill and ingenu-
ity of the physician to the ntiuost, and cannot be re-
lieved by the simple measnres which can bo uudertakeu
at home. Tliere is now and then a case in which ex-
treme dilatation of the colon exists, so that this organ
entirely loses its power to contract upon itself, and
becomes little more than a lifeless sac. In such coses
constant use of tlie enema (22) or coloclystor is the
only means by which the bowels can bo relieved, and
this measure must be employed habitually.

There is no one remedy for constipation so valuable
in all cases as a diet consisting chiefly of granose, fruits,
and nuts or bromose ( Diet List No. 25).

REMEDIES FOR THE HOME TREAT-
MENT OF DYSPEPSIA.

In tho majority of cases of chronic dyspepsia the
patient is more (»r less permanently disabled, and hence
needs to be made familiar with measiii-es of treatment
vhicb he cair himself employ at home, since he cannot
have a physician or nurse always with him, and cannot
live coutjmially at a sanitarium. There is no way m
wliich tlie chronic sufferer from indigestion can so well
accomphsh this object as by placing himself for a few
months under treatment at a thoroughly equipped and
rationally conducted sunitarium. In such cases health
is to be obtained only by a lung aud persevering course
of correct regimen aud careful health culture and train-
ing, which, in order to secure the best results, requires
the personal supcrvieion of a skilled physician and of
trained assistants in carrying out the necessary treat-
ment. As it is impossible, however, that all shonld
enjoy these advantages, the writer has undertaken to
describe sneh measures of treatment as extensive obser-
vation and study in the hospitals of tliis country and
Europe, and many years' experience in the treatment
of various forms of digestive disorders, has led him to
consider most efficient and best adapted for employ-
ment at home.

Before beginning a course of treatment, the patient
shonld read carefully the chapter on " Symptoms, " and
19 [287]

E STOMAOB.

make up hia mind as to the form of djapopaia from
which he ia suffering. The diagnosis being determiued,
he should give careful attention to the prescription for
the treatmiiiit of the particular form of dyspepsia from
which he ia suffering, and should arrange his diet, pro-
gram of treatment, and whole course of life with refer-
ence to the requirements of his malady, no matter how
inconvenient it may be to do bo. Nothing less than
thorough measures will accomplish anything in tlie
treatment of this disease.

It must be remembered, also, that a malady which
has been acquired as the result of long years of traua-
gresBiou of the laws of health, caunt)t be overcome by
a few days or even a few weeks of treatment. Many
months of persevering effort are usually required to
secure penuiinent and favorable results, altliough it ia
just and proper to expect some immediate amelioration
of distressing symptoms wheu tiiey exist.

Not infrequently there is a slight exaggeration o(
symptoms at the beginning of treatment, and sometimes
new symptoms make their appearance. There is often
a slight or even a considerable loss of flesh -for a short
time. Any aggravation of symptoms should be care-
fully considered. The cause may be a miHtako in diag-
jioais, incorrect application of the treatment, or somu
liidiriduul idiosyncrasy which must bo taken into coni
sideration. Aa a rule, any measure of treatment op
regimen which aggravates symptoms should be at onca
discontinued.

A reasonable amount of good judgment and com-
mon sense must be employed in eonnectiun wilh the
treatment recomniende<l ia order ior i\ \o b^ fully eS«ctr

HOME TEEATMKKT OF DYSPEPSIA.

289

ive. Moat of tlie meaanres described tii the following
paragraphs arc designated by numbers, for convenience
of reference : — -

1. The Sponge-or Hand Bath. ^ Soft watetTfl
a soft spoiigo or a linen or cotton cloth, and one or twoV
soft towels or a sheet, are the requisites. The hand
may be used in the absence of a cloth or a sponge for
applying the water. For a saline sponge bath add a
tablespoonfiil of salt to a quai't of water. One part of
vinegar may bo added to three parts of water for a
vinegar spongo bath.

The temperature of the bath should not be above
92° F., and 86° is generally better. Most people can
habitnally employ a temperature of 75° or 80° F. with-
out injury, and some receive most benefit from a still
lower temperature. The use of a much lower tempera-
ture is not commonly advisable, however, and is often
productive of great injury.

Begin the bath by wetting the bead. Bathe the
face, then the neck, chest, shoulders, arms, trunk, and
back. Rub vigorously until the skin is rud, to prevent
chilling ; for even when the temperature of the room is
nearly equal to that of the body, the rapid evapora-
tion of water from the surface will lower tlie exter-
nal temperature very rapidly, unless a vigorous circula-
tion is maintained.

After thoroughly bathing the upper part of the
body, turn the attention to the lower portion, continu-
ing the rubbing of the upper part at brief intervals to
prevent chilliness. As soon as the bathing is con-
cluded, envelop the body in a sheet and rub dry, or
dry llio skin with a towel. When the surface is nearly

290

THB STOMACH.

or quite dry, rub the whole body vigorously with the
bare hand.

Tlio bath should uot be prolonged more than tea or
fifteoD minutes. Five miuutes is a sufficient time to
secure all the benefits of the bath, and even three
minutes wUl suffice.

Persons who chill easily will find it better to bathe
only a small portion of the body before drying it.
Some persons will even find it necessary to rotalri
Bome of the clothing upon the lower part of the body
while bathing and drying the upper part.

This bath may be given to a feeble patient with very
little disturbance, even in bed. Only a small portion
of the body should be uncovered at one time, that being
bathed, dried, and rubl>cd, and then covered while
another part is treated in a similar maimer.

2. The Full Bath. —This bath is taken in an
ordinary bath-tub, which (shcmld contain water enough
to cover the body. For a hot bath a temperature of
100° to luS" F, should be employed ; for a warm bath,
90° to 95" F. When employed for eliminative pur-
poses, the bath should bo continued until the patient
perspires gently. A fnll bath, accompanied by the use
of soap and the flesh-brush, is especially useful oa a
cleansing bath. Care should be taken to lower the
temperature of the bath fifteen or twenty degrees just
at its conclusion, to prevent the patient from taking
cdld. Tlio body should be thoroughly dried after the
bath in this as in all other baths. In cold woatlier,
oil should be applied after the use of soap, to lessen
the danger of taking cold.

BOMB TRGATUENT C

291

3. The Salt Glow. — This is a moat eseellent J
tonic batb. It couHistH essentially in rubbing the whole I
body witb moiat aalt, applied froely to the surface..!
Tlie bath should not occupy more than three to five J
minutes. The salt should be rinsed off bj pouring i

PiU. IS.— SaowKH Uatb.

pail of water over the patient, by a shower bath, or hjA
sponging.

4-. The Shower Bath. — An apparatus such as

in indicated in Fig. ly is the most convenient for this
batii, but water poured through an ordinary colander, j
or the simple device ehown in Fig. 20 may be employed, f

THE STOUACB.

This consists of a. vessel with u perforated bottom, fur-
nished with a hollow tube for a handle. The vessel is
tilled by immersing it in water, and the thumb placed
over the end of the handle, which prevents the water
from running out. When the tliumb is removed, the
water falls through the perforated bottom in a shtiwer.
The shower b^th is usuiillv administered cold or at a
tuinperature of GO" to fSO° F. It should last bat a fow
set'oniU. This is a. most powerful tonic bath, Tlie
shower may be applied to
the whole bi>dy, nt a single
])oint, as over the region of
the stomach and liver, or to
any portion of the truok or
limbs.

The temperature should
be GO" to 811° F. for tonic
effects. In taking a general
shower bath, the patient,
properly prepared, begins
'''■''i''i''V-ii ■.! ;■'■■■''■''"" the bath by ])lacing one hand

Fui. a),-sijiPLK Shower Bath, or one foot under the shower,
and then quickly passing ime arm midor to the shoulder,
tlieu the other ana, allowing the water to fall upon the
chest, then upon the back, and so on until the whole
surface has been exposed to the direct force of the
stream.

5. The Rubbing Wet-Sheet.— This is a very
valuable means of stimulating the skin, and, through
it, the central nervous system ; indeed, it is one of the
best of all tonics. The patient, standing, is quickly
wrapped with a sheet wrung out of water at a tempera*

OF DTfiPEPSIA.

tore of 80° to 90** F. for feeble patientH, and a lower ]
temperatnre for stronger ones. He is tlien briskly ,'
mbbed outside the sheet. The sheet may be renewed ■J
from one to tliree times, according to the strength of
the patient or tlie intensity of the effect desired
(Fig. 21).

6. The Wet-Sheet Pack. — Two or three com-
fortables or thick blankets, one woolen blanket, and a 1
large linen or cotton sheet, are the articles necessary.
It is important that the sheet
be sufficiently large to ex-
tend twice aronnd the pa-
tient's body. Two or raoi-e
blankets are required in cool
weather or by weak patients.
Spread the comfortables, one
by one, npon a bed or
straight lounge, making them
evun at the tup, Ovfr them
Bprend tlie woolen blanket,
allowing its upper edge to
fall an inch or two below
that of the last comfortable.
Wet tlie sheet in water of the proper teniperatm-e, hav-
ing gathered the end in one hand bo tiiat it can be
quickly spread out. Wring bo that it will not drip i
much, place its upper end even with the woolen blanket, ■
and spread it out on each side of the middle sufficiently 1
to allow the patient to lie down upon his back, which
he should do quickly, letting bis ears come just above J
the upper border of the sheet, and extending his limbs
near together. Carefnlly wrap the patient, first with

294

TnE STOMACH.

i th<: blaukt>t, taking paina

tlie sliuot and afterwui'd wi
to exclnde the air (Fig. 22).

7. The Trunk Pack. — Tbis is adiuinistered in
tLe sarao way aa th« WBt-alieet pack, with the oxeep-
tion that tlie applicatiou is eoufined to the trunk of the
body.

8. The Hot and Cold Trunk Pack. — Thia
valujiblo measure is administered in the sann" wanner

a» the trunk pack,
fxccpt thiit a rubber
bug two tbii'ds full
nf hot water is placed
■ over the at'Tiiach be-
fore tlie cold elieet is
applied. A flannel d<ir]i should be placed nest the
skin to prevent injury from the hot bag.

9. The Wet Girdle. —This woh « favorite
remedy with the early German hydropatliists, and tt
ie a wry nsofnl appliance when pmperly employed,
though it has been much abuaed by excessive use. To
apply it well, a coarse towel about three yards long is
the most convenient. "Wet one half of this iu cold
water, wring until it will not drip, and apply it to the
abdomen, placing one end at the side and bringing it
across the front tirst, so that two thicknesses of the wet
portion will cover the abdomen. After winding tiie
whole tightly around the body, fasten the end secnrely
with piiia or with tapes attached for the pnrpose.
Cover all with several folds of flannel.

In cold weather, the moistened towqj should be
covered with oiled mnsliii before the application of the
flannel, and care should be taken to ha\'o tlio dry wrap-

tins 1

Home tekatment of dyspepsia.

pings extend at least two iuches beyond the edges of
the moist towel, to prevent evaporation and chilling.
The colder the water in wliich the towel is wrung, the
more vigorons will be the eifoct produced. For feeble
patients the towel should bo wrung as dry as possible.

10. Futnentation. — ^Fold a soft flannel twice,
so as to make four tliiclcnesses. Dip in vory hot water,
lifting out by the corner and placing in the raidille of
a towel. Roll up quickly in tbo towel lengthwise, and
wring nearly as dry as possible by twisting llie ends of
the towel. In this way the fomentation can bo wrung

TBB ■TOUACH.

out luucli hotter than with the hands. Of course it will
bo too hot to apply to tlie bare fleeh ; but the ekiii
should be protected by one or
more thicknesBes of llaunel, and
the fomentation applied at once,
and covered with another dry
flannel. Renew the iometita-
tion when the lieat begitu to
moderate very perceptibly, and
continne ae long as necoasary
I Fig. 23).

11. Mustard or Turpen-
tine Fomentation.— The ef-
fect of the fomentation may be
increased by adding a tablespoon-
ful o£ mustard to the water from

nO.i'l.— IICIT " iTCH-llAU. ..... . ■

winch the fomentation is wrung,
or by sprinkling over the fomentation cloth when ready *
to apply, an ounce of alcohol in which a leaepoonfid of
tui'pentine lias born dissolved.

12. Dry Heat. — Dry applications of heat may
bo made by means of a rubber bag filled with hot
water fFign, 'H. ■J.'>), healed bricks wrappoi! with flaunt

cloths, flannel bags containing hot stdt. bottles filled j
with hot water, and similar means.

HOME TKEATMKrr OK DYSPEPSIA.

13. The Foot Bath. — Adj vessei sufflcientl;:^
large to receive the feet and enough water to eovopJ
them to the ankles, is suitable for this bath. Tbo tent^^
perature should usually be 100° to 105° F, If theJ
water is cold, it should uot be more than one fourth ot^
an inch deep.

The alternate hot And cold foot bath is a verj vala'
able remedy for cold feet. It is given thus : Place the i
feet in hot water — ^ 100° to IhCF. — for two or three
niinntes. Then withdraw them, and plunge thorn
quickly into a bath of cold water, (>0° F. or leas-
After two or three minutes, realore tlicm to the hot
bath. Thus alternate three or four
times, and conclude by dipping the '
feet quickly into the cold water and wi])-
i»g dry. This bath produces a must
powerful reflex action (Fig. 20). Fio.ai.-riWT iutr.

14. The Sitz or Hip Bath. — For this bath a
common tub may be used, by placing a support under
one edge to elevate it two or three inches ; but it ia
better to use a tub made for the pui-pose, which should
have the back raised eight or ten inches higher than
the front, to support the back of the patient, and the
sides sloping gi'adually so as to support the arms of the
bather. The bottom should 1m3 elevated two or three
inches. The depth in front should bo about the aame |
as that of a common wash-tub.

Enough water is required to cover the hips and ex- 1
tend a little way np on the body. Four to six galloni 1
is about the pro]>er quantity.

A very good plan for administering t
one which will be applicable to most c

THB 8T0M&OB.

Begin the bath at 92° or !13° F. If a thermometer is
not at hand, pour into the bath-tub tliree galloDs of
freBh well- or Bpring-water, and then add one gallon of
boiling water. Tliia
will give the desired
temperature. After
the patient has been
in the bath ten min-
utes, cool it down t«»
85" F, , which may bu
done by adding a
gallon of cold water.
Continue the bath
five mmutes lunger ;
then administer a
F:o. ST.-Ttw sitz BATS TcB. pail douche or spra.v

at about 85" F., and wipe dry, as directed after a baud
bath (Fig. aT).

15. The Sun Bath. — The whole body, unpro-
tected by clothing, should be exposed to the sun, the
head only being covered. The exposure should be
from three to fifteen iiiiiiutee, when a tepid eponge
bath should be administered,

16. The Vapor Bath. —This excellent elimi-
native bath may be easily iuiproviBed by placing the
patient in a chair surrounded by thick coverings, and
heating the water in a pail or small tub placed beneath
the chair by gradually lowering into it hot stones or
bricks. For permanent use, a wooden box may be con-
structed after the plan shown in Fig. 2S.

The skin of most dyspeptics is very inactive, and
with many tlio perspiration has an oScnsive odor. On

HOME TREATMENT OF DYBPBPBIA.

299

this account, a short hot -water or vapor bath may be
taken once a week with advantage. The bath sboold
be continued just to the point of inducing perspiration,
but not longer, as warm bathe are relaxing and debili-
tating. A daeh of cold water over the body, poured
from a pail or by means of the shower, eliould irame-
dintely follow the hot bath. The patient should then
be quickly dried and rubbed, ijo as to secure a good
reaction. Wrapping in a dry woolen blanket promotes
reaction, and is necessary in the cases of some tliiii-
blooded dyspeptics. A full hot
bath, an improvised vapor or hot-
nii' bath, or a hot-blanket pack
may be used as a means of induc-
ing geiitlo poi-a pi ration. The best
of all Buelt nieasurea, however, is
the sun hath or the eloctric-liglit
bath.

17. The Hot.air Bath.—
This is administered in a manner siraihir to tlie vapor
bath, except that the heat is produced by burning alco-
hol in a small dish placed for safety in a vessel con-
taining a little water. The purpose of the hot-air bath
is to induce perspiration, A cold shower or sponge
bath should be applied at the conclusion of the bath.

18. Heat and Cold to Spine. —Alternate
fomentations and cold compresses may be applied,
or alternate hot and cold sponging, if it is preferred,
the alternations being made every half minute, or
mice in one t'> thi'eo minutes Wuler aa hot and
as cold an can be borne should bo used. In some
cases it is necessary to employ ice in order to obtain

IBM fiTOKAOB.

tbt; dosiied effect. When ice is applied to the Rkin,
the enld application eliould occupy only five to teu
seconds.

19. The Hot and Cold Pour, or Pail
Douche. — Two pails of water, one at a teinpenilare
of iao° to 130° F., the other aa cold as can be ob-
tained,- — ice water when a very atrong effect is de-
su-ed,— and a dipper, are the essential requirenietiu.
If the application is to tlio spine, the patient elioold ait
on the edge of the tub wliilo tlio water is poured ujkjd
the ppine from a dipper. The force of the application
may be varied somewhat by the height at which the
dipper ia held. The application ehoiild be alternated
every eight or ten seconds.

20. The Hot and Cold Liver Douche.—
The patient lies in a full-bath Inb while a hot and cold
pour is administered to the right aide, aa directed
above. The application ehuuld continue five to fifteen
minutes. If the patient chills eaaity, the tub may
contain a sufficient amount of warm water to partiaJly
immerse the body.

In casee of hypopepsia and apepaia not accompanied
by tenderness in the region of the stinnach, this douche
may bo emjiloyed with advantage as a means of etinm-
lating the activity of the atomacli glands. The patient
should lie in auch a position that the water will fall
upon a point just below the end of the brejist bone.
The best time for the liver or stomach douclie ia juat
before retiring at night, or an hour or two before din-
ner. A heating compress, or wet girdle (9), should be
applied afterward, and worn over night or during tho
i^geetiou of the meal, in obstinate cases,

HOME TBBATMBNT OF DTSPBPBIAy

301

21. The Hot and Cold Full Bath.— Tho

fill] bath IB prepared in tlic usual maimer, with a tem-
perature of ItiO" F. After lying immersed in water
for about one minute, the patient rises to a sitting
poBtare, A quantity of cold water at a temperature of
tiO" to 70° F. is dashed about the neck and shonldera.
The patient then lies down in the bath for a minute or
two, the water being warmed again. He then sits erect
while the cold application js made as before. The bath
may bo continued from
one to five minutes, con-
cluding with a cold appli-
cation and vigorous rub-
bing.

Another method is to
administer a h&t bath at
a temperature of 100° to
105° F. for five or six
minutes, or until tho Bkin
is reddened. The patient
is then taken fi-om tho
bath, and tho surface
rubbed with a towel
wrnug out of ice- water, or Fm, a»,— STrnosBTBtKOK.
with a piece of ice. The cold rubbing bIiouM be
executed very rapidly. Lastly the patient should be
rubbed dry with a coarse towel,

22. The Enema. — This exceedingly useful ap-
plication of water is best administered by a syphon or J
fountain syringe (Figs. 2^, 80). A bulb syringe may b
employed, but there is always danger of pumping e
into the intestines, and thua giving rise to severe pain, I

302

THB STOHACH.

The patient should lie upon the back. The temporaturo
of the water ehould be 95" to 100° F. When the pur*
pose is evacuation of the bowels, a small cold enema
is nsefnl as a means of stimnlatiog the h>wer bowel.
A large Ijut enema is employed in casea of catarrh or
for the relief of pain.

23. The Coloclyster, — This is simplv a modi-
fied form of the enenia. The patient should lie upon
the right side while the water is being introduced, or
should assume tlie knee-chest position. In the knee-
chest position, the patient first kneels, then bends for-
ward until the head and chest are
on a level with the knees. The
thighs should be- upright, so tliftt
the thighs, trunk, and the surface
upon which the patient ia kneel-
ing shall form a right-angled tri-
angle. The purpoBu of this ap-
phcation is to render possible the
introduction of a larger quaiitit/
of water iuto the colon. Three
or oven four quarts can be thiu

.-YKi.voE. introduced in eomo cases.

24. The Cold and the Graduated Enema.
— The cold enema ia a powerful means of stimulating
intestinal activity. Tlie quantitj' of water used should
not be greater than half & pint in ordinary cases.

The tjraduated enema consists of an ordinary
enema gradually cooled from day to day by the addi-
tion of half a pint of cold water, tho total amount of
water employed being at the same time diminished.
The amount of water need each day should be loesened

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HOME TREATMENT OF DYePEPaiA.

303

sufficiently ao that by the em] of ten days or two weeks ^
the total quantity used will not be more than _a pint, ]
and the temperature 60" to 70" F. In a few days
more, if proper diet and other measures are employed,
the enema mav t>o discontinued.

FiQ. Jl.-Wiiefi Bottle and s^mrNoe

25. The Laxative Enema. ^ In cases <
treme constipation it is sometimes necessary to employ i
a laxative enema. Strong soapsuds is excellent fori
this purpose, and is effective in most cases. It U |
sometimes necessary to odd conunon salt to the -9

804

THB BTOIUCB.

in the proportion of a tablespoonfiil to the quart. The
following mixture may also be advantageously em-
ployed in very obstinate caecs : Snlpbatc of magnesia,
one tablespoonful ; glycerin, one tablespoonful ; boil-
ing water, two tablespoonfule. The mixture should
be introduced as high up in the bowel as possible, a
catheter being uf^ed for the purpose if necessary.

26. The Oil Enema. —Two or three ounces of
oKve oil introduced into the rectum at night serves as
a sufficient remedy for constipation in certain cases.
The oil enema may also be advantageously used in
cases in which hardened masses of fecal matter have
accumulated in the intestine, and cannot be removed
by tlie ordinary warm-water enema.

27. Oil Rubbing. — Applications of oil are
always made after certain kinds of baths. Ordinarily,
a tepid sponge bath is first given, after which tlio oil
is systematically applied to the entire body witli vtjf-
orous rubbing. Any excess of oil remaining should
be wiped away. ' Olive oil, cocoanut oil, or even
vaseline may be employed.

28. Massage — Kneading. — Superficial aod
deep kneading, as illustrated in Figs. 1 and 3, Plate
VI, are among the most useful procedures employed
in massage. The movement is that of firmly grasping
and then releasing the tissues. The purpose ia to
knead and manipulate the skin and the muscles so as
to stinmlate the circulation and other vital activities iq
these structures.

29. Abdominal Massage.— (Fig. 3, Plate yi,>
The operator endeavors to seize the abdominal content^
yt\1.l\ both hands, manipulating thera precisely ft^ ^

- !

HOME TREATMBST OF DYSPEPSIA.

baker does a mass of dough, the fingers of one hand
being naed in 0])po8ition to the heel of the other hand,
and the abdominal contents kneaded and manipulated
between the two hands. In this procedure the heel of
one band of the manipulator operates npon the side of
the patient nearest him, while the fingers of tlie other
hand operate upon the tissues of the opposite side.
This method is only applicable to cases in which the
abdominal walls are considerably relaxed. This, as
well as most other forms of abdominal massage, requires
the Bcrvices of an assistant, the patient lying upon a
bed or couch,

30. Massage of the Bowels. — (Fig. 4, Plate
VX,) With the closed fists used in alternation, the
operator works along the whole course of the colon,
beginning at the lower end of the cecum, directing tliu
movements upward to the lower border of the ribs on
the right side, following the oblique border of the
ribs to a point midway between the umbilicus and the
sternum, at which the median line is crossed ; then
down on the opposite side, ending at a point close
to the pubic bone, and just to tlie left of the median
line.

If the patient is able, he should make a practise
of kneading and percussiiig the abdomen himself for
fifteen or twenty minutes night and morning. This is
a powerful stimulant to muscular activity. Many
years ago a quack doctor in Kew York City made n
fortune by treating dyspeptics by this method alone.
He put every patient under an oath of secrecy, anil
required certain wholesome restrictions of diet, whitli
of course {tided in the cure.

306

TBB BTOUAOB.

31. Massage of the Stomach. — (Fig. 5, Plato
VI.) With the patient lying upon the back, the assist-
ant BtandB upon the right eide, with his buck to the
patient, and execntea the following movementB : Placing
the right hand upon the left side of the abthfiQcn oppo-
site the umbilicus, with the fingers extended and close
together, he presses the ulnar border of the hand back-
ward, at the same time carrying it upward with a vibra-
tory movement. Following along under the riba of
the left side, he continues the movement upward to the
epigastrium. At this point, before releasing the tia- j
sues, ho places the tips of the fingers of tlie left hand
so as to support the tissues at the point to whicli they
have been lifted by the niovenient of the right hand,
making firm pressure ; then withdrawing the right
hand, he repeats tiie movement. Tliis is onitiTincd for
three or four minutes. If it is desired to empty the
stomach, the strokes should be miTied across the epi-
gastrium, and along under the lower border of the ribs i
of the right side. Tlio following movements are espo- 1
cially useful in aiding digestion : — -

Execute the movements just described, and at the
same time have the patient breathe deeply. With
every alternate breath the patient should execute what
the writer terms insplrntory cfimprt'tminn, tlms ; Fill-
iug the lungs completely, hold the breath for a few
seconds, and at the same time raise the head forward ,
as far as possible, strongly contracting the abdominsll
muscles.

Gentle kneading of tho abdomen, especially itsi
upper portion, is an excellent means of sliinulatii^ J
muscular activity on tho part ot the stomach, and tlim^

- b

HOME TBEATMENT t

307

preventing too long delay of the food in this part of
the digestive apparatus. By this means the local cir-
culation is stimulated, and t!ie natural muscular action
of the bowels is both imitated and encouraged. This
is an excellent remedy, and may be employed to advan-
tage each uiglit and morning, and for half an hour or
more after each meal.

32. Replacement of the Viscera. — (Fig, (t,
Plate VI.) The patient lying upon the back, with the
head — not tho shoulders — elevated, knees well drawn
up, the operator places his hands at the lower portion
of the abdomeii and presses inward, lifting upward at
the same time. The patient should relax tho abdominal
muscles as perfectly as posaiblo, and should take full,
deep respirations. With each expiration the operator
endeavors to lift the contents of the abdomen a little
higher, holding the hands firmly during tlie inspira-
tion, 80 as not to lose the ground gained. The patient
should take full, deep inspirations, expanding tho waist,
and lifting the chest well.

33. Inspiratory Lifting of the Abdominal
Contents. — A number of years ago the author dis-
covered a method by which tlie abdominal organs may
be forcibly lifted into position by a simple modification
of the breathing movements. The mt-lhod is as fol-
lows : The patient, lying upon the back, after fully
emptying the lungs, executes the same movements as
in ordinary inspiration, but, by closing the throat, pre-
vents the admission of air to tho lungs. Care is taken
to raise tho chest as high as possible, and at the same
time to draw in the abdominal muscles with as much
force as possible. Tlie result is, that, no air b«.vt^

308 ' TBE STOUACH.

admitted to the lungs, the stomach, bowels, anj^^
viscera are sucked up into the chest in a very forcible
manner. Bj grasping the lower abdomen with the
hands, and lifting upward at the same time this move-
ment is executed, the effect upon prolapsed organs may
be greatly increased. Fig. 7, Plate VI. shows very
clearly how this movement is effected.

34-. Hacking. — This consistB in stroking the
part with the &ige of the hand, the fingers being
separated, as shown in Fig. 8, Plate VI.

35. Beating. — This pro-
cedure of massage consists in
striking the body with the half- I
closed fist, as shown in Fig.
Plate VI.

36. General Massage. — \
Qenerjil massage consista in the
rubbing and manipulation of the
whole body. The movements
are chiefly those doscribed as fric-

FiQ.as.-AiiMFLiLiioN. tion and kneading (28). Thosa i
movements are applied to the limbs and back. A\>- 1
dominal massage (29) and massage of the stomach and I
bowels {30, 31) are employed for the abdominal r&. 1
gion ; hacking and beating (34', 35) for the sptneJ
(Figs, s and 9, Plate VI), especially iho lower part oC'l
it, the fleshy portion of the thighs, over the liver, \
and the large nerve tranks.

Joint movements, or flexion of the arms and 1
with resistance, are employed iu general masst
The patient is made to draw the limb up while 1
assistant offers slight resistance to bis doing s

;T of DYaPKPElA.

patient then extends the limb wLile the assistant makes
resiBtance in like manner. The movement is repeated
several times, the number of times and the aniouut
of reeistance offered being regulated according to the
strength of the patient. Figs. 32 and 33 illustmte arm
flexion and extension. >

An expert is required for the administration of
massage in a thoroughly skilled manner. In another
work* the author has given a full description of the
various procedures and manipulations i

37. Exercise. — This is
of first importance as a general
renovator of the tissues. The
secretion of gastric jnice is, un-
der ordinary circumstances, pro-
portionate to the amount of (
nourishment which the system
is prepared to assimilate. Ex-
ercise creates a d e m a n d fur
■ food, and so stimulates both as-
similation and secretion. Tho^
best forms of exercise are those
which will secure the moat uni-
form activity of the several parts of
system. Riding, walking, rowing, and es
back riding are to be recommended as excellent.
nastic exercises and the jndicioue use of the "health
lift " are also good ; and for persons who, for lack of
time or for any other cause, cannot adopt the other
methods, those may be considered as almost indis-

■ ■■ TbB Art of Mttssafje." Modern MedlflUB Publishing Co.. Battle

THK BTOHAOH.

peuBaijle. Such txerci»eH &s running, jumping, base-
ball plajing, walking matchoe, and other violeut exer-
cises cannot be rocommendt'd. Trapeze exerrise must
also be discouraged on tlie mnmc grounds. Agricultural
labor, especially the raising of small fruits and tlif cul-
tivation of flo\vt>r8, eanaot Iw too highly recotiuncuded
as forms of exercise for dyspeptic patients. For that
large class of sal low- fated, weak-backed young ladies
who have been made dyspeptics by idleness and too
much coddling by fond mothers, the varied excrciseB
of domestic labor are a most admirable panacea. And
for the gauut, hollow-cheeked, sunken-eyed young man.
whose principal occupation is cultivating a moustache,
smoking cigarettes, and swinging a slender cann, a lit-
tle wbolesome experience iu earning a eubsietoncc by
the sweat of his brow, instead of depending upon
wealthy relatives, will i)rove a specific for the "soft-
ening" which begins in the brain, and estcnds to
every part of the systeiu.

Exercise before breakfast, while excellent for some,
may be very harnifnl for others. Persona who com-
plain of a feeling of "gonenesB," "faintness," "eink-
iiig," and allied pains when the stomach is empty,
and especially in the morning, must avoid exercise to
any considerable extent before eating. Disregard of
this rule often occasions loss of appetite and weakening
of the digestion. Persons who are very weak most
also avoid exercise before eating in the morning.

As before remarked, only gentle exercise can be
taken soon after eating, or immediately before, without
uijnry. Persons who feel a constant "sinkJug" or
weakness in the stomach and bowels, will derive benefit

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DYSPEPSIA. 311

from wearing about t!ie body a broad band of flannel.
In many oE tlii-sB cases the Natural AbdurainaJ Sup-
porter will be found of great advantage. It is in these
cases especially that complaint is made that walking
prodnces coldness in the extremities, instead of serving
to worm them.

One of the most marked effects of exercise u}>on
digestion is to increase the activity of the gastrio
glands, and thus promote the secretion of the gastric
juice. This has been clearly shown by recent exi^ri-
ments. It is hence apparent that iu hyperpepsin little
or no exercise should be taken immediately after oatrJ
ing, whereas in hypopepsta moderate exercise after )
eating may pro\'e beneficial by increasing the activit
of the gastric glands.

Enrcises to Develop the Abdomitial Muscles.-^ De-
velopment of the abdominal muscles is one of the moat)
important of all curative measures in chronic indigc'tt*
tion, since its most obstinate forms are due to prolupaa
of the stomach, and those forms of conjttipation least
benefited by a regulation of the diet or other curative
means arc usually the result of prolapse or dilatation
of the colon. Development of the abdominal muscles^
benefits cases of this kind by holding the prolapsed \
organs in place, and also by increasing the pressurQ'J
within the abdominal cavity, aa well as the cxpuliii
power. The following are among the mosl cxeellenti
exercises for developing the abdominal muscles :

(1) Lying upon tlie back, raise the head forward asl
far ns pnsaible without the use of the arms. Repeat^
every five seconds, breathing in as the head goes back,
and breathing out as the head is raised forward.

THB STOHACH.

(2) Baiee the right leg as liigh as posaible, and
return to position. Repeat with the left leg, then with
both tegB. Empty the luuge as the leg is raised, filling
the lungs as the leg is lowered to position. Repeat
each exercise three to twenty times.

(3) Combine exercises 1 and 2, following the eame
instructions in regard to breathing (Fig. 10, Plate VI}.

(4) Lying upon the back, with the togs extended,
rise to the sitting position without using the arms.
Slowly return to the horizontal position ; repeat three
to twenty times. Exhale while rising to the Bitting

Trdnk tlDsct-es.

position ; take one full breatli after each movement.

(5) Repeat exercise 4, with the hands placed at the
top of the head, and the elbows extended sideways and
in line with the body.

(i>) Lying npon the face, place the trunk, elbows, .
and toes in such a position that the whole body will be
BQspended upon the elbows and toes. Lower the center
of the body until it rests npon the supporting surface ;
then raise to a horizontal position, repeating three to
twenty times (Fig, 34),

(7) Lying upon the back with the knees drawn up,
separate the knees as widely as possible, then bring
them together again. The assistant should meanwhile
make resistjince to each nioventent by pressing first

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HOME TEEATMENT OF DYSPEPSIA.

313

on the oater, then the inner surface of the knees (Fig.
11, Plate VI.)

(8) An excellent exercise for strengthening the
abdominal muscles is the following : Standing with
the feet separated as in Fig. 39 (page 319), and the
hands placed :ipon the hips, the patient bends gently
forward until a strain is felt upon the abdominal mus-
cles, then rises to position, repeating the exercise a
number of times.

38. Breathing Exercises. — The following ex-
ercises in breathing will be found verj helpful to diges-
tion. Before engaging in them it is well to take a
little vigorous general exercise, as jumping up and
down or a short run, which will create a thirst for air.

(1) Breathe in the ordinary maimer for one minute,
taking care that the greatest expansion is at tlie sides
of the waist.

(2) Fill the lungs as full as possible, breathing
slowly in and out, forcing the sides of the chest out as
far as possible. Be careful not to confine the breath-
ing to the upper part of the chest. Occupy equal time
in breathing in and out, — about five seconds each for
inspiration and expiration (Fig. 12, Plate VI}.

(3) Take a deep breath occupying about two sec-
onds, and breathe out in pufis, occupying about five
or six seconds in expiration,

(4) Take a quick, deep insjtiration, expanding the
lungs as fully as possible, and follow with a prolonged
expiration, sounding the syllable "ah. "

(5) Standing or sitting, repeat each of the above
exercises, at the same time raising the arms from the
sides to a horizontal position while inhaling, and allow-

814

thb eroHAOH.

F10.8S.— Lvnca. KneBsKotKii.

ing tlicm to return to positiou by the sides wLilv
exhaling. ,

(0) Repeat exercises 1 to i, raising the arms from
the sides to a Tertical positioTi, reaching overhead as
high as possible at tbe
end of iuspirnrion. and
allowing the arms to re-
turn to the sidos during
expiration.

(7) C/i€>it L(ff!nff.—
In Fig. 30 is shown «
most excellent exercise,
which, however, r p-
quires the aid of an
assistant. The patient
sits in a chair while
the assistant stands
behind him. The assistant benils forwaid, grasps the
arms a few inches below tlie shonMcrs, and lifts them
npward and backward, the patient drawing in his
breath at flie same time. Tlie arras ehonld be drawn
npward far enough to produce b decided strain upon
the chest walls. After being held in position a few
seconds, the arms are retnmed to the sides. TTie
movements are repeated ten to twelve times a
minute, the patient taking a deep breath after each
movement. The clothing should bo loose enough to
allow the orgjios of respiratitm free play.

Manual Swedish Movements. — Among the
most important of all forms of exercise nseful in indi-
gestion, must be mentioned Swedish medical gyrnnos-
tics, or what are ordinarily termed "manual Swedisb
movements. " Fnll directions for tbe employment of

nOME TREATMENT OF DYSPEPSIA.

315

tnannal Swedish movenients in disease will be found
in a moat excellent work no "Swedish Movements,
or Medical Gjmnastics," Ii^ Professor T. J. Kartelitm,
M. D., director o£ the Central Gymnastic Institute of
Stockholm, Sweden, recently translated by Dr. A. B.
Olsen, and edited by the writer ; published by the
Modern Medicine Publishing Co., Battle Creek, Mich.

The following groups of movements have been
found especially valuable in the treatment of eases of
chronic indigestion: —

39. For General Debility and Anemia. —

Re|>eat each of the following movements fonr to
eight timea : —

I. Lying, full breath-
ing (38) (Fig. 12, Plate
VI 1.

1'. L y i n g, knees
drawn np, knees separa-
ting and closing ivith re-
sistance (Fig, 11, Plate
- VI) (37 p]).

3. Replacement o f
the abdominal organs
(Fig. 0, Plate TI).

4. Alternate head
raising and leg raising for-
ward (Fig. llJ, Plate VI).

5. Sitting, arm,
fiexion, extension and rol-
ling (Fig*. 82, :)?.) (m).

6. Lying, iDspirator^ lifting (Fifg. X,, VWaNV^_

Bepeat each of the following movements four to |

eight times : —

1. Inspiratory lifting (Fig. 7, Plate TI).

2. Lying, knee bending and stretching (Fig. 35). j

3. Hacking over liver, stomach, and spleen (Fig. 8,
Plate VI).

4, Sitting, armn extended sideways, arms rolling.

5, Lying, raise trunk to sitting position ^37 [i]).

6. Lying, knee bending and stretching.

7, Replacement of abdominal organs (Fig. 6,
Plate VT).

8. Sitting, cheat lifting (Fig.. 36) (38 [7]),

HOME TREATMENT OF DTBPEP8IA.

317

40. For Dilatation of the Stomach.— The

following movements may aleo be employed for dilata-
tion of the stomach and prolapse of the stomach and
bowels, which are usually present in cases of nervoua
headache : —

Repeat each of the following movemeiits four to
eight times : —

1. Chest lifting (Fig. 36).

2. Lying, knees bent, knees separating and cloeing
(Fig. 11, Plate VI) (37 [7]).

3. Sitting, arm raising, full breathing (38 [5]).

4. Standing, hands upon the hips, backward
bending.

5. Lying, knee bending and stretching (Fig, 35).

6. Lying, leg and head raising in alternation (Fijf-
10, Plate VI) (37 [1, 2, 3]).

7. Sitting, neck twisting and bending.

K. Inspiratory lifting (Fig. 7, Plate VI).

9. Reach-eupport-standing, sacrum beating (Fig. 9,
Plate VI ; Fig. 37).

10. Sitting, gentle backing ot head (Fig. 8, Plate
VI), stroking head and neck downward.

41. For Prolapse of Stomach, Bowels,
Colon, Kidneys, and Other Abdominal Or-
gans.—

Repeat each of the following movements four to
eight times : —

1. Chest lifting (Fig. 36).

•2. Replacement of abdominal organs (Fig. 6,
Plate VI).

3. Lying on back, leg and head rt^ising (Fig. 10,
Plate VI) (37 [1, 2, 3]),

318

THE ETOUACa.

4. Inapiratory lifting i^Fig. 7, Plate VI).

5. Lying, knees bent, kneatiing of abdoialnal
muscle B,

G. Sitting, knees separated, tnmk twisting right
and left.

7. Lying, raise to Bitting position (Fig. 3 ■)
(37 t*)).

8. Sitting, lient forward, raise backward witlj pres-
sure npon the loins.

9. Rejjeat exercise 2 with inspiratory lifting,
10, llcpeat exerciao 3.

42. For Dyspepsia with Dilatation of the
Stomach. —

Kepeat each of the fol-
lowing niovemontB four to
light times : —

1. Chest lifting (Fig.

'J. Keaclhs n p p o r t-
standing, spine hacking
and sacrum heating (Figs.
S, !", Plate VI; Fig. 37).
3. Lying, knees bunt,
kneading the stomach
(Fig. 5, Plate VI; Fig. 3»}.

+. Lying, leg and head raising (Fig. 10. Plate
VIJ (37 [1, 2, 3]).

5. Arm raising, fall breathing (38 [5]).
(', Lying, knees bent, pressing under right and left
ribs witli vibratory movements.

7, Sitting, trunk twisting to right and left,

8. Repeat exercise 3.

1 TREATMENT OF DYSPEPSIA.

9. LyiDg, knees beot, kaees separating and closing
with resistance (Fig. 11, Plate VT) (37 [7]).

in. Repeat exercise 6.

11. Standing, forward bent, sacrum beating (Fig.
37).

43. For Constipation. —

Rejieat each of the
following iDdvements four
to oight timi?8 : —

1. BtAnding, leut
separated, sideways Ix-nd-
ing to right and loft | Fig.
39).

2. Chest lifting (Fig.
36) (38 [7]).

3. Sitting, twisting
to right and left. '

4. Inspiratory lifting '"'^.-vf^^r^""'"
(Fig. 7. Plate VI).

5. Lying, kaeea bent, kneading of the colon (Fig.
4, Plate VI).

6. Head and leg forward raising (Fig, Ki, Plate
VI) (37 [1, 2, li]).

7. Sitting, feet separated, describo a large circle
with tlie head and shonlders, holiliiig the trunk straight
and the hips stationary.

8. Repeat exercise 4.

9. Reach -support- standing, sacrum beating (Fig,
37).

10, Sitting, arms stretched above liead. hend arms
with resiatance, back supporttnl by the knee of the
attendant.

THE BTOMACH,

44. The Dry Abdominal Bandage.— A dry

tiaimol bandage worn about the abdomen is often ofl
great value m oases of indigestion. The whole abdo-
men, from the lower end of the steninni to the pubes,
should bo covered by the bandage, which sliould fit th<
skin eniigly. It should always be worn during tlie daj-
time by persons who wear the wet girdle at night.

45. The Abdominal Supporter. —The aV
dominal supporter (Fig. 4li) consists, first, of two hard
rubber piods connected by an elastic wt,bbing, nbioh'

lest againit tlio lower abdo-
men being caiefully shaped
so as to make a unifortq
prmsufL, and second, ii 91
of steel springs attached to
back piece, and so adjusted
as to make piessure upon
the hard rubber plates simul-
taneously backward and up-
ward Tlie action of thi
supporter is almost a perfect
imitation of the hands
lifting the prolapsed ab-
dominal contents. After trying every form of sup*
porter offered in the market, I have fonnd the Natoral
Abdominal Supporter naoro satisfactory than any other,
and have employed it in a very large number of
It is manufactured and sold by the Modern Medlctiu
Company, Battle Creek, Mich.

46. Lavage. — The accompanying cut (Fig. 4l)
shows an approved form of stomach-tube, which U
used in obtaining a test meal for the examination of tk«

- I

HOME TREATMENT OF DYSPEPSIA. Ii21

stomach flaid, and for waBhiug out the stomach when

The most snitahle time for washing the stomach is '
juat. before retiring :it uigbt, or five or six hours after
the last meal. The operation is by no means so diffi-
cult or distressing as it might appear. The tube em-
ployed is of very soft, flexible rubber. It is not forced
down into the stomach after the fashion of the old
stomach-pump, but is simply swallowed as one would
swallow a portion of food or a capsule. One end of
the tube being introduced
iuto the mouth and passed
well back into the throat, the
patient makes movements
of swallowing whereby the
tube is readily carried into
the stomach. Water of
about the temperature of the
body is then poured in,
either with or without the ad-
dition of common salt and soda iu the proportion of a
teaspoouful of each to a quart of water. A powder
consisting of three paite of bicarbonate of soda, one
part of sodium sulphid, and one part of chtorid of
sodium, may be advantageously used in cleausiug the
stomach, one teaspoonful of this powder being added
to each pint of water used in cleansing the stomach.
After a pint or so of water has been poured into the
stomach, tlie outer end of the tube is lowered, and by
coughing or similar movements tlie contents of the
stomach are forced through the tube into some proper
receptacle. Repeat imtil the water is clear.

THE STOMACH.

Hot and Cold La^vage of tlie Stotnacli, — The pnr-
poae of hot and cold lavage of the stomach is to stimii-
]ate the secretion of pepsin and hydrochloric acid iu
cases of hypopepsia and apopsia. The geucral mtsihod
is the same as that for lavage. The temperature of the
fluid nsed may vary from 70° to 120" F., and tlie
quantity from half a pint to a pint. Ordinarily, at tho
beginning, the extremea of temperature should not be
more than 20° F., or S5° to li)5° F. Alternate hot
and cold applications are a powerful means of stimnlat-
ing vital activity, and the method is as serviceable
when applied to muctius membranes as to the skin.

^T. Charcoal.— Charcoal is valuable by reason of
its remarkable absorbent qualities, whereby it takes up
the poisonous substances produced in the stomach, thus
preventing their absorption. It also exercises a vt>ry
remarkable influence in preventing certain forms of
fermentation in the stomach. It should be impalpably
fine, so that it will not produce irritation of tho mucous
membrane, and should be freshly prepared, Tho author
has succeeded in preparing, and has for many years
employed, a special form of charcoal made from cere-
als, which he has found to bo very much superior
to the willow charcoal obtainable at tho drug-stores.
Charcoal must be taken in large doses (a heaping tea-
spoonful at leaat) to bo of any service. It is best taken
by mixing with a little water. At first use just enough
water to moisten, then add more.

48. Charcoal Tablets.— The Modem Medicine
Company, Battle Creek, Mich,, U. S. A., have suc-
ceeded in preparing charcoal in tho foi-m of tablets,
which are more convenient for nse than the pulverized

HOME TREATMENT OF DYSPEPSIA.

323

charcoal, as tbey can be handled readily, and taken witb
out water and without inconvenience, besides retaining
their active properties indefinitely.

49. Antiseptic Charcoal Tablets.— These
tablets are also prepared by the Modern Medicine
Company, and are found to bo the most effective
means of preventing fermentation and decomposition
in the stomach. They are especially valuable in acid
and bilious dyspepsia, and in cases in which the tongue
is heavily coated,

50. Lactic Acid. — Lactic acid, in the proportion
of one ounce of the acid to three of water, is a useful
remedy in cases of hypopepsia without fermentation.
The dose should be one tcaepoonful in water immedi-
ately after each meal.

51. Hydrochloric Acid. — Hydrochloric acid, in
the proportion of one dram of the acid to three ounces
of water, is useful in cases of hypopepsia and npcpsia,
but should not bo used habitually. Two teaspoonfuls
in water, half an honr after each meal, constitutes a
dose ! a second dose may her taken half an hour later.

52. Laxatives. — Such fruits as tamarinds, figs,
manna, and prunes, with a tablcspoonful of bran mixed
with boiling wattir, aro all food laxatives of value in
many cases. Antiseptic charcoal tablets (49), three or
four after each meal, also have an excellent laxa-
tive effect. The advantage of these tablets is that their
continued use does not destroy their efficiency, aa is the
ease with most laxatives.

53. Cascara Sagrada. — The fluid extract of
cascara sagrada is one of the most valuable of all
drags for temporary use as a laxative in cases of iaacr

THE STOMACH.

tivity of the bowels. The dose ia fifteen lo thirty
drops of the fluid extract taken at night in a little
water and before breakfast, for a few days. It should,
however, be uscd only for a sliort time, as it usually
loses its effect when long continued.

54. Aqua Salina. — This is composed of anl-
phate of soda, one and one half ounces ; sulphate of
magnesia, one half dram ; sodium chlorid, one foartb
dram ; water, one pint. One fourth lo one half a glass-
ful, diluted with cold water, should be taken before
breakfast. This is an excellent substitute for the beet
of the laxative mineral watern, but should be used only
in case of emergency, when the enema cannot be em-
ployed, and should not be long continued.

55. Seltzer. — This is composed of sulphate of
magnesia, one ounce ; tartaric acid, three and one half
ounces ; bicarbonate of soda, four ounces. The dose
is two to four heaping teaspoonfule, in water, before
breakfast. Use same as 54.

56. Sulphur. — Sulphur is an old-fashioned but
useful remedy as a laxative and intestinal antiseptic.
It should bo taken in ten-grain dosos three times a day,
or in doses of one half a dram at bedtime. It may bo
mixed with a little molasses or brown sugar.

57. Antiseptic Dentifrice. — This excellent
preparation for cleansing the teeth is based upou the
extract of the bark of the famous soap-tre« of South
America and aromatic antiseptics. It may be obtained
of the Modern Medicine Company, Battle Creek, Mich,

58. Cinnamon Solution. — Add two teaspoon-
fids of oil of cinnamon to a pint of water ; shake thor-
oughly. Tliis is to bo used as a lotion for rinsing and
washing the mouth.

BOUS TBZATMKNT OP DYBPEPBIA. '^SS

59. The Perfection Vaporizer. —This is au
excellent instrument for the vaporization and nebu-
lization of medifated
eolations for nse in
the treatment of af-
fections of tlie throat
and nose (Fig. 42).
It is for sale by the
Modern Medicine
Company.

60. Benzuin A\ "^l

Solution. — Gum

benzoin and all other

balsams and essential „ , , „ ^

Flo- 43, — PERFErTios Vaporizer.
Otis are antiseptics,

and, used by means of tlie Perfection Vaporizer, are of
great value in the treattuent of dises^sea of the nose
and throat. The folhiwing solntiou, in which benzoin
is one of the principal ingredients, has been found
especially valuable : —

Q CompounO Tr. BcDzoin. . . ilrniB. (i
Oil Cinnamon, Oil Wln-
lergreen, Oil Eucalyptus,

~",|lli Mi-niliol Crystals aa. •Mm. 1

-■•' Alcolifil drtna. 15

61. Guaiac Solution.—

B Menthol Crystals.
Oil Eucalyptus, Tr.
(:uaiac,...au.drm. 1
Akohol drms,

02. Subcarbun-

"i-llin ' i|t)(|-«|P''«iii'!iiii||||'"''"-»ia*e of Bismuth.—

I Subcarbonuto and sub-
Fio. 43.— Vapobizkr in Use. t\\ttM» q1 \iYKO.\jSa. «.i<*

Wi^^^

326 THE 8T0MA0B.

two very usefnl drugs, which may be frpqnenlly used
to advantage in casoa of indigestion acconijianied by
great irritation of the mucous membrane, and aro in-
valuable in ulcer of tlic stomach and in hyperpepBia,
The doBB ie fifteen to thirty grains before each meal.
When lavage of the stomach gives pain, it should be
followed by a dose of twenty to thirty grains of snbni-
trate or Bubcarbonate of bismuth.

63. Subgallate of Bismuth. — Snhgallate of
bismuth is an excellent intestinal antiseptic, five to ten
grains to be taken before each meal. It is especially
valuable in eases in which there is a tendency to looee-
nesB of the bowels, as it is somewhat atttriiigent in
its nature. It has a tendency to produce constipation
when its use is loug continued. It is, on this account,
inferior to antiseptic charcoal tabli?ls (^9) as an intes-
tinal antiseptic, but is especially valuable in cases in
which an intestinal antiseptic is required in connection
with an irritable condition of the stomach and in cases
of intestinal catarrh.

64. Bicarbonate of Soda,— This much-abused
drug may be usefully employed in hyperpepsia and
ulcer of the stomach, in which it should bo taken in
twenty- to thirty-grain doses, just before eating, in very
severe cases, or two or three hours after eating in caaefl
of less severity.

65. Local Applications of Faradic Elec.
tricity, — Care should betaken that the sponges arc
moist, the conducting cord in good repair, and the
battery in good order. Strong currents are generally
best for relieving pain. When it is desired to exercise
the muscles, the sponges should be applied near the

HOUG TREATMENT HV nVSrEPSlA.

327

edges of the muscle, and tlie current should be rapidly
interrupted by' removing the B])onge and replacing it,
BO as to produce repeated muscular conti-actions. The
application of electricity to the poctum is a most excel-
lent means of relieving constipation. A special elec- 1
trode is required for the rectum, a large, flat sponge i
being placed over the abdomen. In the absence of a J
special electrode, a small spimgo may be applied to ]
the amis.

66. General Applications of Faradic Elec.
tricity.^As a general tonic, the current is applied
in the following manner : A large, flat sponge is placed
at the feet or connected with the feet by means of a
foot bath, one sponge being dropped into the bath
while the other sponge is passed over the whole surface
of the body, — first the spine, then the arma and legs,
then the tmnk, — the strength of the current being
sufficient to create a slight tingling sensation as tlie
sponge is brushed over tlie eurface, without producing
muscular contraction.

For muscular effects, the following mode of appli-
cation is employed ; Two sponges, held a few inches
apart, are applied to the muscles of the arms, legs, and
trunk in such a way as to cause strong contraction of
the muscles. By frequent interruption of the cm-rent
by the removal and replacement of one of the sponges,
repeated contractions are produced. Thus all the mus-
cles of the body may be exercised.

67. The High Tension Sinusoidal Cur.
rent. — This current is obtained from a specially
constructed electrical apparatus fsee Fig. -14), and i
particularly efficacious in relieving pain, often sacceed*.

THE STOUACU.

ing when other means fail. The current ia applied the
same as the faradic currcut (65, 66).

68. The Low Tension Sinusoidal Cur-
rent. — This current is obtained from the same appa-
ratus as the preceding, but by a different atljustraent of
the machine. It ia especially useful f*ir exerciae of the
mnscles, especially those of the trunk and abdomen.
It is very valuable as a moans of relieving chronic con-

stipation. When nsod for this purpose, a metal elec-
trode is placed in the rectum, and a large sponge over
the abdomen. The current should bo of sufGcient
strengtli to cause \-lgoroiiB contraction of the abdominal
muscles. The abduntinal niu»ck-e are thus strengtltcned
and the nerves of the rectum stimuhited,

69. Galvanization of the Spine and Ah.
domen. — A galvanic battery of thirty to fifty cells ia
required. A sponge about the widtli of the hand and ten
or twelve inches in length is placed upon the central por*

HOME treatue:

329

tion of the spine. Aootlier sponge of the same length,
and twice as wide, ia applied over the abdomen opposite.
As strong a current is passed as can be endured by tlie
patient without severe pain or injury to the skin. The '
sponges should be well moistened, and should be
closely adapted to the skin. Clay electrodes secure
better contact than sponges.

70. Galvanization of the Sympathetic i
Nerve. — A galvanic battery is required as indicated J
in 69- A sponge the size of the hand is placed at the 1
back of the neck, and another twice as large is placed \
over the umbilicus or the epigastrium. A cnrrent as 'i
strong as the patient can bear witliout injury to the 'i
skin is applied from ten to twenty minutes.

The Rest-Cure. — A course of rest-cure treat-
ment is indicated in cases in which there ia excessive J
nervous irritability, combined with nervous exhaus-]
tion, and especially in cases in which emaciation i
prominent symptom. Rest -euro sliouM be followed!
by "General Nutritive Treatment," and afterward bya
"General Tonic Treatment," fur which it ia a prepa-l
ration.

FoBM A.

1. Absolnte rest in bed, with exclusion, of friends, 1
is demanded. The patient should bo kept quiet, and.]
encouraged to exorcise tlio ntind as little as possible, to 1
sleep all ho can, and to rest both physically and mentally.

2. The patient should take four meals a day, — twa I
major and two minor, — the major meals preferably at '
S A. M. and 3 r. m. ; the minor meala at V^ h, and

7 p. M., and should eat as much aa can be digested. |
The major meals may conaist of any of the artidegj

TRB STOUAOB.

included in Diet Lists Nus. ;i, 3, and 10. The minor
menls should be confined to the articlee found in Diet
LiBtB 5 and 6, or euch funds as are very quickly digested,

la cases in which the digestion is very ranch im-
paired, it is better to confine the diet chiefly to kumy-J
zoou or buttermilk, and eggs. Bromose and granof
(Diet List No. 1^5) are also especially nseful in thesft |
cases. Bromose may be taken as a substitnte for milk
in cases in which milk does not agree well with the
stomach. It is a most excellent food for the minor
meals. When obtainable, granose should be used at
the major meals as a means of regulating the bowels.

The patient should, on awakening each morning,
have di-y friction applied to the whole surface of tho
body by the band, or, better, with a rough towel or
a soft flesh-brusb. At 10 a. u., hot and cold applica-
tions should be made to the spine (18), to be followed
by a tepid sponge bath {I). Massage (3ti), at first
very light, should be applied with increasing vigor
from day to day. After tho first week, the muscles
may bo exercised by flexion and extension of the arms
and legs, the patient making resistance (see Figs. 32
and 33). Tho bowels should ho moved daily by means
of the enema (22), if necessary. Tlio action of the
stomach and bowels Bboiild bo encouraged by massage
of the stomach (31) and kneading of the bowels (30).
Symptoms of indigestion should receive attention as
elsewhere reeoraraendod.

Form B. — Modified Rkst-Cuek,

The same measures recommended in Form A should
be employed, but tbe patient should be given a litt le

HOME TREATMENT OF DYSPEFSiI

3.11

exercise out of doors for an hoar or two daily in a
wheel-chair, or at first lying upon a cot. After a few
daya the patient may be allowed to walk a little, bat
should spend at least half the time each day in bed.

Form C.

Tho measures recommended for " General Nutri-
tive Treatment," eombiued with rest in bed the greater
part of the tmie, should be employed.

General Nutritive Treatment. — The por-
poae of nutritive treatment is to improve the patient's
nutrition by increasing the demand for food, hence the
appetite, and tims enlarging the store of food and blood
in the body without overtaxing tlie nervous system.
Xutritive treatment is required in the case of very
young and very old persons.

The following series of [jrescripLions are progress-
ive. Feeble patients slifiuld begin with A ; while
strong patients may begin with B, or even C. The
patient should be promoted at the end of one, two, or
three weeks, to the next prescription, and after com-
pleting this uutritivD series, should begin the tonic
series, page 333.

Fomentation over the stomach and liver every
morning before rising, to bo followed three times a
week by a tepid sponge bath (90" F.). rubbing with
oil, and on other days by dry friction with a soft flesh-
brush or a coarse towel.

General massage and massage of the stomach,
bowels, and liver, about li) a. m. daily.

333

THE 8TOM4CB.

A short, warm full bath, with soap shampoo, fol-
lowed by an oil rob, taken just before retiring at siglit,
oDCe a week.

Carriage riding, walking, bicycle riding, or otheE
exercise iu the open air euited to the patient's strength,
from one to three hoars daily.

Sun bath five to fifteen minntes daily, or whenever
possible.

Swedish movements (39, A), daily.

Breathing exercises before and after each nteal.

One or two hours' rest in a horizontal position be-
fore dinner.

Warm full bath {'.<o° F. ), with a cold pour over th<i
spine and the liver twice a week. The bath ehouM b»
cooled to 80" F. for ten or fifteen seconds at the close,
and followed with an oil rub. This bath is best taken,
at night just before retiring.

Hot and cold sponging of the spine for ten
fifteen minutes every morning, followed by a tepid
sponge bath (85" F.) and an oil rub, with hackin|;
over spine and liver.

Soap shampoo once a week.

Sun bath, out-of-door exercise, and massage as iu A.

Swedish movements (39, B).

Short vapor, Turkish, or hot-air bath, or a wet-
sheet pack continuing twenty to thirty minutes, twicq
a week, followed by an oil rub at about 10 a. m. or
uight just before retiring.

HUME TSKATaENT OF DYSPEPSIA. '-VA'S

Fomentations to the spine for fifteen minutes, fol-
lowed by a cool (75° F.) sponge bath and an oil nib
every morning.

Swedish movements {39, B).

Exercise, sun baths, and massage as in A, with in-
creased vigor.

General Tonic Treatment.— One of the es-
sential features of tonic treatment is the application of
cold water. Water is one of the best of all tonics.
This treatment is indicated in cases of general debility,
anemia, and most forms of chronic disease. It is only
contra-indicated in tJie cases of feeble, very yonng,
and aged persons, and in those in whom there is a
high degree of irritability or excitability, Tlie treat-
ment should bo made progressive. The feeble patient
should begin with A, being promoted at the end of two
or three weeks to B, and later to C. After completing
the entire series, the patient may advantageously con-
tinue some of the measures recommended, as a regular
habit, particularly the cool morning sponge or shower
bath, followed by vigorous rubbing, and the regular
daily exercise out of doors.

Hot sponging of the spine, a cool (80° F.) towel or
sponge bath every morning before rising, followed by
hacking of the spine, spatting of the general surface,
and oil rubbing.

At 10 A, M. general massage or Swedish move-
ments.

General applications of electricity — faradic (66) or
Binasoidal (67) — daily.

THE STOMACH.

Swedisli movements (39, A).

Exercise out of doors, csirriage riding, horseback
riding, bicycle riding, according to tbe patient's
strengtli, daily from two to four honre.

In addition to A, the patient should three times
a week take fomentations ovt^r the stomach and liver,
followed by a nibbing wet-sheet. This treiitraent may
be given at bedtime, unless the patient is apt to bo
greatly fatigued at night. In each cases it should be
taken earlier in the day, but not within two boors of
a nieal.

Swedish movements (39, B).

Tht! patient should talte, each morning, a fomenta-
tion o\'i'r tiie abdomen, hot and cold sponging of tlie
apine, a cold (75° F.) sponge bath, followed by an
oil rub, hacking over the spine and liver, and general
massage.

At 10 A. u. or at bedtime, three times a week, a
cold wet-sheet pack for twenty to thirty minutes, fol*
lowed by a rubbing wet-sheet and an oil rob.

Swedish movements, general applieationa of elec-
tricity, massage, and out-of-door exercise as in A
and B.

Mechanical Swedish Movements. — For
many years I have made use of uiechanical means
iu the treatment of indigestion and constipation. Pa^
tionts under my care have derived special benefit from
the use of the vibrating chair, the kneading apparatns.

ROME TKESTMEST UP DYSPEPSIA,

335

and tlie trunk-sliakitig apparatus, wMch are illustrated
in Plates VII and VIII. Tlie following dosciiption
of these miiehiues is copied fi'om the author's work,
"The Art of Massage," previously mentioned : —

"?:(<> Mbrating CAam— Fig. 2, Plate VII, rep-
rusents a vibrating chair de^-ised by the author in lH'^'Ay
and in constant use since tliat time at the Battle Creek
Sanitarium. The usual rate of vibration employed is
twenty per second. A person needs to experience but
a single application to become convinced of the power-
ful physiological effects which may be produced by
mechanical vibration. When seated in the chair,
strong vibratiiiry movementa are experienced, in which
tlie whole body takes part. The greatest amount of
force ia applied to the lower portitm of the trunk.
The vibratory irapnisoa communicated are felt power-
fully in the lower bowel, and have a dei-ided stimulat-
ing effect upon the rectum.

"jV(Wki«kw^ Knmdlng, — Mechanical kneading of
the alxlomcn is one of the most useful of the several
forms of kneading ; indeed, it may perhaps with justice
be said to be the moat useful of all. It is best admin-
istered by means of the apparatus shown in Fig. 1,
Plate Vni. This apparatus, which the writer had
constructed for the purpose several years ago (18S3),
and has had in constant uae since, consists of a table
with a large aj>ertaro near the center of the top. In
tills opening plays a aeries of eix vertically placed bars,
each surmounted by a suitable pad. Each bar ia sepa-
rately actuated by a cam, or eccentric, so that it has its
own independent motion. These six eccentrics are so
arranged as to give a wave-like form to the combined

TBS STOMACH.

Itaneouan

inovcmcriU of t!ic six kneading pads. Simnltaneoi
with the vertical movement of this kneading devic^
the table-top, witli the patient which it bears, is uia<Ie
to move back and forth, thus changing the relation ol
the pads to the abdominal surface, and caosing tliei
to knead the entire abdomen. The two eeta of mow
tnentH are bo tiniod that the wave-like kneading mon
ment is made to follow very closely the conrae of tt
colon, thus bringing this part of the intestine especial]
under control.

" 7Vm«A Rdling. — The apparatus represented i
use in Fig. 1, Plate VII. consists of a pair of pnli^
moving in alternation and in opposite directions, ,
fraction of a revolution in each direction. To ead
pulley is attached one end of a broad strap, which
passed around the trunk in such a manner that, Ba d
strap is pulled first in one direction and then in tl
opposite, the tissues are acted upon very mncb as i
certain forms of palmar kneading. When appli«
about the waist, it is a very excellent means of admil
istering a rolling movement to the muscles of tli
trunk, and a shaking movement to the viscera ; when
applied to the shoulders, the effect is that of deep
kneading. This apparatus, devised by the aatbor
about ten years ago, is a favorite with patients who
are under treatment by mechanical massage. Its ap-

ingO^

plication is so vigorous that it is not continued longi
than from two to four minutes,

' ' Peloiif Tlltiity. — The parpose of this device ( Fi^
3, Plate Vn ) is to aid in restoring the prolapsed organe
to a normal position. Tlio apparatus consists of a tilt-
ing table which moves rhythmically from a horizoo]

HOMK TREATMENT OF DYSPEPSIA

positioD to that shown in the cut, in which the position
of the patient ia such as to cause the abdominal organs
to be dragged upward by gravity. It ia very useful
in relieving pelvic congestion and other symptoms
commonly present in eases in which the pelvic and
abdominal -organs are prolapsed.

''Mechnnical Rmjnratkm. — ln Fig. 3, Plate VIII,.
is shown an apparatus by means of which artificial res-
piration may bo mechanically administered. In its use
the patient is seated upon a stool, the arms being placed
over movable rests, which fall in the axilla;. The back
is supported by a padded rest placed between the shoul-
ders. When the machine is set in motion, the shoul-
ders arc lifted upward and backward in such a way as
to expand the chest in an efficient manner, producing
a strong inspiratory movement quite independent of
any effort on the part of the patient. The effect is to
correct the condition known as flat or hollow chest,
and to give flexibility to the chest walls when they
have become rigid in ciinsequenco of iusutticient uso.
This apparatus Is in part modeled after a similar ar-
rangement by Zander, but several improvements have
been atlded ; among others being a device by means
of which the arms, as well as the shoulders, are raised,
tlins increasing the vigor of the inspiratory movement.

'■^ Cannon- Ball Maesage. — A cannon-ball covered
with leather is a valuable mechanical accessory in the
application of abdominal massage. A ball weighing
from four to six pounds is usually employed. The ball
is simply rolled upon the abdomen, following the
course of the colon from right to left. I have found
the canuon-ball very useful when employed in connec-

338 Thb stomacb.

tioii with utLcr Measures of treatment. It has tliiA'
iidvantagt', tliat it may bo employed by tbe patient
himself. It ehoulJ be uaed for fiftpen minutes morn-
ing and evening. In the morning it may be employed
jost before rising, or half an hour after breakfast."

Water-Drinking. - — In cases of obstinate con-
stipation, due to inactivity of tlie liver, water-drinking
is of advantage, if the stomach will bear it. The qnao-
tity of water which can be taken will vary from a single
glassful before breakfast to six glassfuls a day in the
intervals between meals. Kepeated experiments by
the most eminent physiologists have shown that the:
liberal nse of water as a beverage is a great promoter
of vital activity, not only of the liver, but of other vital
organs. This measnre must not be cari'ied to excess,
however ; it should be discontinued if it distnrba di-i
gestion.

Water- drinking has been very much abnsed withiii
the last twelve or fifteen years, since it was broaght;
prominently before tlie public by I>r. Salisbury and
Dr. Cutter, of New 1 ork. In cast-a of dilatation rf
the stomach, which is very common among dyspeptics,
constituting nearly one half the entire number, copiood
water- drinking is often productive of groat mischief.
The dilated stomach being unable to absorb fluida
rapidly, and retaining for a long time the large quaa*i
tity of water introduced, becomes abnormally distended
and overweighted, and the patient's condition is thai
aggravated rather than benefited. The use of Uu
stomach-tube in washing out the stoniaeh largely obvi
ates the necessity for copious water-drinking. In case)
in which water-drinking must be interdicted o

HOUE TREATMENT OF DV8PKFS1A.

of dilatation of the stomach, a sufficient amount of
moisture may be supplied by alowly introducing a
quart or two of water into the colon daily, preferably
at night, allowing iib much of the liquid to be absorbed
as pottsiblc.

The Hunger-Cure. — Fifty years ago the hunger-
cnre was much practised by the followers of Dr. Joel
Shew, aud at the primitive water-cures which were at
that time to be found in various parts of the Middle
and Eastern States. The advocates of the hunger-cure
extolled it so highly, however, and used it so indis-
criminately, that it fell into disrepute, and faating is
now seldom mentioned aa a mode of treatment. How-
ever, the wiiter is of the opinion that abstinence from
food is one of ttie most important and valuable of eui-a^
tive measures in a groat variety of morbid conditions, 'j
and especially in certain forms of indigestion. ,

The fasting exploits of Drs, Tanner and Griscom, I
who abstained from food for forty and forty-two days *
respectively, and of the Italian faster who, in London, -
under conditions of strict surveillance, abstained wholly
from food for the full period of sixty days, have dissi-
pated the erroneous notions formerly held respecting
the immediate necessity of food as a condition of life.
The body contains within itself a considerable store of
nutrient material, upon which it is able to draw in case
of need.

In all conditions in which the system is laboring
under the iutluonco of poisons absorbed from the ali-
mentary canal, abstinence from food is the surest and
sometimes an indispensable means of prompt relief.
These intestinal poisons are due to the action of germs,

340

THE STOMACH.

lubstftDOeq

of mi-
■wjnire
iig rid

OQt M

, Bcntf

and result from the decomposition of food sul
consequent upon the growth and development of mi-
crobes. Germs, like other living organisms, rwjni
food for growth. Tlie quickest method of getting rid
of them and their evil effects, is to starve them oot
abstinence.

The advantage of withholding food in fever,
rheumatism, and inflammation of the stomach andj
bowels, has long been recognized. Fasting is equally
useful in many eases of biliousness, bilious dyspepsf"
and dilatMion of the stomach. Nothing will so quick^
relieve an attack of sick-headacbc as abstinence trot
food. Fasts of two or three weeks' duration, as prai
tised in water-cures half a centnry ago, are not, faow
ever, to be recommended ; but the omission of a tm
when one feels slightly indisposed, with loss of app<
tite, and perhaps slight headache, will often prevent
more sorions illness, and quickly restore the vital eqm
libriom. A nimiber of years ago the writer succeeds
in effecting a cure in a case of very pronounced dilatl
tion of the stomach, by requiring tlie patient to abstv
from taking food by the mouth for two weeks. Nm
tion was maintained by means of the nntritive enen
At the end of the two-weeks' fast the stomach a
found to be reduced to nearly its normal dimenaioi

I had under my eare at one time a lady who man
years before had submitted to the hunger-cure. Th
patient was sutfering from obstinate constipation,
result of prolapse of the stomach and colon, and dili
tion of the colon. She claimed that the two-wee^
fast which she had undergone some twenty years bj
fore, had resulted in a complete cure of the eoi

HOUE THEATMENT OF DYSPEPSIA.

tioD for more than twelve yeai's. So severe a. measure
is not necessary, however, in cases of this kind. A
proper regulation of the diet, the support of the pro-
lapsed viacera by a suitable abdominal 8upport«r (Fig.
40, page 32lJ), and the employment of euch curative
measures as electricity, manual Swedish movements,
gymnastics, and hydrotherapy, will suffice to effect a
cure, if employed intelligently and perseveringly.

Fasting methods can very easily be abused. Fro-
longed fasting should never be undertaken without the
advice and cai-eful aupervision of a physician. I have,
in my experience, met with very few instances in
which I have thought it proper to advise a prolonged
fast, but have in a great number of cases observed de-
cided benefit as the result of omitting a few meals, or
fasting for a day or two.

Great benefit may be received from what might be
termed a partial fast, in which the patient subsists
wholly npon some one simple article of food luken in
moderate quantity. Fruit, as ripe apples, grapes, or
peaches, is best suited for this purpose. The effect of
such a regimen, which may be followed for a week
without injury, providing the patient is resting, is to
purify the general system in a wonderful manner, first,
by preventing, through the destruction of microbes, the
production of poisons in the alimentary canal, which
overtax the liver in their destruction, and the kidneys
in their elimination ; and, second, by encouraging the
activity of the kidneys in removing impurities from the
blood. Fruit is a natural diuretic.

Healthful Dress. — As has already been men-
tioned, dress is a matter of no small consequence in

the twatineiit of ehroiiiu dyspepsia. Any press OT
iipoD \im stomach ia liiglily injurious. Men, as wc
as women, frequentlj' suffer injury from constrict,
the waist, iii supporting their clothing by means of
belt. The writer has met with two cases of floatit
kidney in men, in which the condition was evidentl;
due to c<intr&(;tiou of the waist. In one case a btat^
smith had usually supported his clothing by mean
of his leather apron-strings tied tightly aboat
waist. In the other case an army officer had b
injured in the same manner by the constrictioD of
Bword-belt.

The clotliing should fit the body so loosely 1
there will be ample room for fall expansion of
chest at the waist ; otherwise, with each inhalatioi
the stomach is crowded down out of position. Th
clothing should be wholly suspended from the shotitq
ders, not merely by straps, but by waists ; or it is atjltj
better to wear what are known as " union garments^ " '
which tho upper and lower garments are nnited in oih
Plates IX and X show some excellent designs £l
bealtliful dress for women which have been designl
in the Dress Dcj>artmeut of the Battle Creek San
tarium, from which patterns may be obtained.

In addition to wearing the clothing loose daoi
to give every organ perfect freedom of action, it is
the greatest impoitauce tliat the extremities be k4
thoroughly warm. Cold hands and feet are very ci
mon with dyspeptics. It will generally be found I
to wear flannel uiidergarmenta throngliont the y<
graduating the thickness to tho temperature. In i
(reme cases oi disturbed circulation, it may be

TREATMENT OF DYSFSFSEA

BSry to change the clothing once or twice a da}- to
accomplish this.

Sleeping. — It ia of great importance that suffi-
cient sleep be obtained hy those suffering from indi-
gestiott, though sometimes tin's seems impossible on
account of the nervouaueas occasioned by this disease.
It is generally best to retire early, but there is no virtue
in getting up in the morning at an early hour unless
the body is recuperated by rest. Sleep must be ob-
tained, and on many accounts it is better to take it in
the forepurt of the night ; but if not secured then, it
should be taken at other times. Sleeplessness induced
by anxiety is often a cau^e of dyspepsia. It is a gi'cat
obstacle in the way of successful ti"eatmeut.

It is an excellent practise to retire for rest for an
hour or two before the mid-day meal. Many dyspep-
tics ai-e able by this means to recruit sufficient energy
to digest the second meal, while otherwise they suffer
from indigestion after dinner, although capable of di-
gesting breakfast without difficulty.

Traveling. — Many physicians are in llie Imbit
of recommending patients upon whom t\wy liave <j\-
hansted their akill, to seek hoaJlh by traveling. Thou-
sands annually leave their homes, and at great expense
visit various watering- J daces, mineral springs, etc.. in
this country and in Europe, iti accordance with such
advice. Some return much benefited ; but the ma-
jority are no better except for the rest. This ia due
to the fact that traveling does not remove the real
cause of the difficulty, and may often increase it. In
general, it is next to impossible to secure, while fr-ivfl-
ing, either regularity of meals or other habits, vr :i

proper quality of food. This, of course, to a great
degruc counteracts the benefit which might otherwiiw
be derived.

The advantage of special climates is unUonbtedlr
very greatly overrated, thuugh a cool climate may gen-
erally be coDBidered as best, especially for those suffer-
ing with bilions dyspepsia. With nervous dyspeptics,
however, a warm climate Heems to agree better, aa it
occasions lesa disturbance of the circulation.

Mental and Moral Treatment. — This is u>o
important a part of a successful plan of treatment to be
neglected. The gloomy despondency which so com-
monly goes with this disease, must be steadily combated
by a determination to be cheerful. The disposition to
fret and worry, and to dwell upon tlio unpleasant or
painful features of one' a ctmdition, must be fought
against with firmness and resolution. The dyspeptic
who allows his mind constantly to dwell upon faia
stomach, and who speculates npcm the prohabilitit-s
respecting the digestion of each uiorael ()f f(HMl as be
swallows it, will be certain to remain a dyspeptic.
This unfortunate tendent-y on the part of sufferers
from this disease is a great impediment to recovery.
The mind should bo diverted from self as much as
possible at all times, and especially while eating. The
habit many dyspeptics have of talking constantly about
themselves, which sometimes araonnis almost to »
monomania, cannot ho too strongly condemned. Too
great solicitude about the stomach, the diet, etc., {a_
worse than none at all.

QUACKS AND NOSTRLMS.

There is no class of inalaiiiea tbo victims of which
have been bo constantly aud extensively u prvy to the
quack and t!io patent-medicine vender, as disoi'dcrs of
the stomach. The chronic dyspeptic, daily tormented
by the discomforts of his malady, eagerly seeks relief ■
from any Bource, and is readily beguiled by the decep-
tive and alluring deseriptiona of newspaper advertiaerB,
patent medicine almanacs, and manufactured testimoni-
als, to try first one and tlioa another of the thousand
and one nostrnms which are displayed upon the drug-
gist's ahelvcs and catalogued upon c<inntry barns and
fences. Quite a large proportion of dyspeptics thos
become addicted to the use of patent medicines. The
writer has met many persons who might very jnstly
be termed "nostrum maniacs." They eagerly scan
every newspaper that comes into tlieir hands for the
announcement of some new medicine of this kind, and
as soon as possible obtain it for trial.

The great charm of the patent medicine is the se-
crecy thrown about it, and the idea often positively
maintained — always encouraged — by the manufac-
turer, that his particular nostrum cimtains some newly
discovered remedy, the virtues of which have been en-
tirely nnknown to seientifio medicine. One of the beat
means of dissipating this fallacy is to cxjxise the faot
(.3*4 1

346

THE STOMAOB.

well known to the snientific physician, that all patent
medicines an<l nostrums arc either inert and wortblees,
because of theu- inefficiency or their injitrions obaracuir,
or else are simply cheap and well-known drugs with
which every physician is familiar, and which may bo
obtainod from any druggist for a very small fraction of
the pi'ice charged for the nostrum. As a rule, the first
cost of the patent medicine is scarcely one twentietli
the price charged for it. The manufacturer puts his
ill-gotten gams into newspaper advertisements an<]
huge signs painted upon board fences, burns, rocks,
and conspicuous places along highways and railroadx,
iustea^l of iuto the mediciue bottle. For an cx()06e it
is only necessary to publish the composition of Uicim>
nostrums. Here are a few of them : —

Stviujhton Bitters. — Orange peel, li oz. ; gentian
root, 8 oz. ; Virginia snake root, I^ oz. ; American saf-
fron, i oz. ; red saonderH, i oz. ; alcohol, 4 pts. ; water,
4 pts.

£r/>i/'fi'n Iron Btfters, — Trim, 1 gr.; caUsaya bark,
2 gr.; phusphoruB, 1-200 gr, ; coca, 1 gr,; viburnum
prnnifolium, I gr.

IIiij) Bittern. — Hops, 4 oz.; orange peel, 2 ot.\.
cardamom, d dr.; cinnamon, 1 dr.; cloves, J dr.; aloo~
hoi, 8 oz. ; sherry wine, Spts. ; simple sirup, 1 pt. ;
water, sufficicut.

Himtettei-'' K Bitters. — These bitters contjiiu, accord-
Jn^ to the Mcilical BvlUtin, the following ingredients :■
.Sugar, 2 lbs.; calanms root, '2 lbs.; orange peel, 2 lbs.;
Peruvian bark, 2 lbs.; gentian root, 2 lbs.; colnmbo
rooti 2 lbs. ; rhubarb, 8 oz. ; cinnamon, 4 oz. ; cloves,
2 oz.: diluted alcohol, 4 gals.

347

Oei-nuin Bitters. — German camomile, 2oz,; sweet
flag, 2 oz. ; orris root, 4 oz, ; coriandtT seed, 1^ oz. ;
centaury, 1 oz. ; orange peel, 3 oz, ; alcohol, 4 pts. ;
water, 4 pts. ; sugar, 4 oz.

StiiiiKich Blttcra. — Gentian root, l^oz. ; cinchona
bark, ^ oz. ; orange peel, 2^oz. ; cinnamon cort., \ oz. ;
aniso seed, ^ oz. ; coriander seed, ^ oz. ; cardamom scwl,
i oz. ; gum kino, \ oz. ; alcohol, 1 pt, ; water, 4 tjts. ;
sugar, 1 lb.

French Absinthe. — Oil wormwood, 1 dr. ; oil melisa,
15 drops; oil anise, "2^ dr.: oil star anise, "2^ dr.; oil
fennel, 4 dr. ; oil coriander, 3 drops ; alcohol, 14 pta, ;
water, 6 pts.

Vintfgar Bitta's. — The following is Dr. Gibbon's
account of the origin of Walker's Vinegar Bitters,
a specimen of which the writer analyzed several
years ago, and found to cnutjiin five per cent, of
alcohol : —

"This 'bitters' is one of the nastiest nostrums,
and is introduced and largely sold by the most cxtcu-
sive and brazen advertising under the false pretense of
being free from alcohol. It originated witli the cook
of a party which traveled overland as a mining com-
pany to California in 1849 ; he settled in Calaveras
county, and having no success as a miner, turned his
attention to the bitter qualities of the herbs growing
about him, and came to San Franciseo with the idea of
making and vending a nostrum to bo called ' Indian
Vegetable Bitters.' Ho felt in with an enterprising
druggist, who saw money in the project, and joined
him. At the suggestion of the latter, the ' Indian '
was struck out, aud as the concoction got sour by fer-

348 THE BTOUACH.

inentution, it was concluded to call it ' Vinegar Bitter^
and to identify it with tbe temperance movement. Th
native lierbs, which became rather troublesome to col
lect, were discarded ; and aloes, being a cheap bitt«
was substituted. ' Nine sick people out of ten,' sai
the druggist, 'will bo cured bv purging,' therefore tb
aloes and Glauber's salt. Si> the cook turned doctoi
the decoction became sour, and of Ciilifornian iasteaq
of Indian paternity, and ' Dr. "Walker's Vinegar Bittem*|
began its career in the newspapers and on the shelve
of the drug-stores."

The statement has recently been made that ' ' Vii
gar Bitters" is now manufactured of sour Iwer a
aloes.

L-y's A/'t;-B>/''(MM /'///«.— Calomel, 3(J gr.; jali
fin gr. ; gamboge, li! gr, ; tartar emetic, 3 gr.

Trojilv Fruit Lax(ttu-e. — Jalap, ]>owdered. 6 paitfla
senna, powdered, b parts ; sugar, 5 ^&n» ; tamarioj^
pulp (E. I. ), 30 parts.

C'irte.)' H LitiU LIi't PiU«. — Podophyllin, IJ gr.;
aloes (Socotrine), 3^ gi-. ; mucilage of acacia, sufficient.

Shiton'9 Livtr ^^yu/rt^cA— Hepatica, 1 oz. ; h
tandra, I oz. ; eerpentaria, 1 oz. ; senna, 1\ oz.

Radical/ » liegulath-g PHU. — Each box cc
from twenty-nine to thirty-one sugar-coated pilli
unequal size. They consist of 30 grains of aloes,
grains of jalap, 8 grains of gamboge, and some
substance.

Eiui'if Fruit Salt. — Soda bicarbonate, 168
tartaric acid, 150 parts ; Rochelle salt, HO parts,

Hamhurg Tea. — This is composed of senna 1
and stems, coriander fruits, manna, and tartaric

QUACKS AND SOSTRUMS. 349

Garfield Tea. — This consista chiefly of senna leaves
snd couch grass.

Holl<nvay'« P'llU. — Aloes, 2 dr.; rhubarb, 1 dr.;
cflpsicnm, 20 gr. ; saffron, a gr. ; sulphate of soda, 5 gr,

ffamlnifg Drops. — Powdered Socotrine (aloes), IJ
oz. ; American saffron, \ oz.; tincture of myrrh, 16 oz.

R. V. Purree's Ph'a«ant Purgative Pellets. — Each
little bottle contains from twenty-eight to thirty-sii
small Bugar-coated pills of unequal size, and weighing,
in all, from eighteen to twenty-two grains. Their ca-
thartic effect ie due solely to podophyllin, the resin of
the root of the May-apple.

Dr. JTalVa So-called " Secret.'''' — For several
years, a man styling himself Dr. A. Wilford Hall,
of New York City, has been advertising and vending
about the country a pamphlet purporting to disclose a
discovery made by himself something more than forty
years ago. The so-called discovery of Dr. Hall's is
this: —

Having had dyspepsia for a number of years, and
being greatly troubled with constipation, he resorted to
the enema as a means of emptying his bowels, and
discovered, aa he asserts, that it waa possible to inject
a gallon of water into hie colon by means of a bnlb
syringe.

This is the whole of Dr. Hall's so-called diflcovery.
He recommends the enema as a substitute for nature's
method of relieving the bowels, to be employed by all
persons, sick or well, and claims that persons who will
adopt this method of relieving the bowels, will be proof
against most of the diseases to which human flesh ie
I heir, mentioning particularly such disorders ae Bright's

TBK STOMACH.

disease of the kidneys, emallpos, and other grave and
contagious maladies. This so-called discovery ia em-
bodied by Dr. Hail in a cheaply printed pamphlet cost-
big about two cents, for which he charges the modest
sum of four dollars.

Some three or four years ago, the writer, in the
magazine of which he ie editor, Good Ht^tli^ exposed
in a most thorough manner the fraud perpetrated by
Dr. Hall in professing to be the discoverer of the
enema as a mode of emptying the bowels. Whoever
was the discoverer of this method of mechanically mov-
ing the bowels, it certainly was not Dr. Hall. Dr.
Shew, a water-cure physician, advocated the method
in this country some years before Dr. Hall professed
to have made the discovery, and PreiBsnitz had em-
ployed it long before. The enema may be properly
used as a means of emptying the bowels when they are
not emptied by the unaided efforts of nature, and is
preferable to the habitual use of laxatives or cathartics
of any sort ; but the practise of daily introducing a
large quantity of water into the alimentary canal, has
the effect to destroy the normal sensibility of the
bowels, and to establish an abnormal condition, bo
that this lai-ge amount of water becomes necessary as
a stimulus to provoke an evacuation of the intestinea.

It was long ago discovered by physicians that the
habitual use of the enema as a means of stimulating
the movement of the bowels, is by no means free from
evil consequences. Chronic constipation cannot be
cured by this method any more than by the use of
cathartics. It is only a mechanical means of emptying
the bowels, which ia undoubtedly preferable to the re-

QDAOKS AND NOSTRUMS.

351

tention of fecal matter ; but at the eoiue time it is not
a cure of the morbid condition, and a person who habit-
ually uses the enema becomes as much dependent upon
it as is the habitual nser of mineral water or pills, opon
these agents.

A person who has become dependent upon the
enema as a means of moving the bowels in consequence
of following the erroneous teachings of Dr. Hall, may
find relief by the employment of the graduated' enema
(24), massage of the bowels (30), and the Swedish
movements recommended for constipation (43), to-
gether with the adoption of other measures which are
elsewhere recommended for the relief of constipation
(see page 273),

It may be added that the author's exposure of Dr.
Mair^ fraudulent claims resulted in destroying his ne-
farious business, in this country at least, but he suc-
ceeded in pocketing a hundred thnnsand dollars or
more before bis business was interrupted by the pub-
lication of his en-called "cecrct."

Explanation of the Author's Qraphic Hode of Ren
resenting the Results of Stomach Work 01^
tained from the Examination of the Stomach
Fluid by the System of Investij^atiun Employed
in the Hygienic and Physiological Keseard
Laboratories of the Sanitarium at Battle Cre«fl
Hich.. U. S. A. 1

In tLia Bcheme for the graphic represeutation of tM
results of the analysis of stomach fluids (Plate X^
the firBt fivo columns relate to the work done hj tig
Btomacli in as many different phases of its dlgeflti«4
and chemical activity. The remaining colmnnH arc
devoted to the coefficients of digestive work, by refer
ence to which one may see at a glance the relation ol
the work done, in quantity or quality, to tlie normal
standard. The figures in the several columns repro-
sent, at the bottom, the lowest figures, and at the t
the highest figures, which have been observed in t
examioatiOD of more than five thousand stomach flu:
The figures included in the dark-colored band wh]
passes acrosB the center of the chart, represent the i
mal limit. The significance of the figures shown in i
several columns is as follows : —

The letter A' indicates the total work ilono bjr i
stomach in setting free the hydrochloric acid net
13521

^■i

GRAPHIC REPRESENTATION

Cau

a/ - -

cocrriCKNTS or oiqcstive work.

MWT

FnRi.

TiU

tUNl

Clftmi.

IcKti,

ttintU.

a 1

_4_

.130

.!10

-iio

.4S0

1.00

!.00

S.00 1

» e.ofl

10.00

.<J0

.Hi

.500

.440

6.iO

l.flO

4.00

iO 1.00

9.00

>«^

.8ftJ>

.!I0

.»:o

.410

a.is

I.SO

1.S0

l« 1.80

8.00

1.?^

.s:«

.103

.»iO

.SS3

e.00

1.00

10 l.jO
HI*

-.00

i::J.

r <*

.3i*.

.ISO

.H30

.300

t.IS

1.05

a.30

0.00

.»a3

.105

•lis

.3J0

G.iO

J.il)

3.00

:;:3,

t.:w

.JSO

■,.150

.w»

'-.tto

t.S5

1.^

tlJ

3.00

t H

.90.1

•AX,

,«^s

.aop

fi.Oft

i:ii»

a.-w

4.30

Xiol

iia

.tM

Mtt

'.s:o

.200

«.!S

C4t

r.si

*, 1.41

(Ai

ii.3^

.lis

.11*

.iai

.a;!

4.S0

f.llt

£.00

a ,1.40

\*-'y

?-l

.SM

.100

•SIO

.STO,

«.»

j.3i-.

i.;s

v»

ijAj

.9IS

.ow

.t»

.tli-

4.00

3.80'

■ .so

/:3o

i..«!

IJoS

.no

.«u

.tio

.330

■.»

I.IO

I.!i'

tss

.tse

.070
,0M

.too

.sto
_.«o

a^o
,a.ti

n.so

l:S|

\;?

■■^^^^^^^^^^■1 1.IO

1.10

.ftl

^^^^^^^H «.K> ^^^H

.80

^^^H^^l"'' H^H

1 ''S,.

"I'l!

EMl.iMJ4» .m

■i'

.Vi

.(0
,M
.W

i|i

.SO

"■.»

tekS^fS-SS'

■^

-:a

_: '"

.10
.00

1 m

a 1 b 1 c

PLA-SV. XV.

OH&PHIC its

353

for digestion. If the figures found by analysis fall
below the normal limits, that is, below .180, the case
ie one of hypopepsia ; in other words, the stomach
does lees than the normal amount of work. If the
zero point is reached, the case is one of apepsia, and
the stomach is doing no digestive work whatever. If
the figures fall above the normal limit, that is, above
.200, the case is one of Lyperpepsia ; in other words,
the' stomach does more than the normal amount of
work.

In the treatment of apepsia and hypopepsia, all
proper means are used to increase tlio activity of the
gastric glands, thereby supplying the deficiency of
hydrochloric acid. The principal means to be adopted
are, licat over the stomach, massage, electricity, the
moist abdominal bandage, exercise after eating, a hot
and cold douche over the stomach.

In cases of hyperpcpsia, or excessive formation of
hydrochloric acid, the aim of the treatment adminis-
tered is to lessen the glandular activity of the stomach.
It should consist of hot sponging of tiie spine ; an ice
bag over the stomach in extreme cases ; galvanism to
the spine, the stomach, and the pneumogastric nerve ;
and tlie avoidance of all stimulating foods and con-
diments.

The figures of the second column, H, relate to the
amount of free hydrochloric acid present in the stomach
fluid. When it is remembered tliat free IICl is neces-
sary, not only as an aid to digestion, but as a means of
preventing the growth of germs and the production of
poisonous substances through the decomposition of the
food, the importance of this determination will be ap-

35+

THB STOHACB.

predated. Free hydrochloric acid may be abaent, defi-
cient, or present in either normal quantity or in exccBs,
in both hypopepsia and hyperpepsia, as well as in case*
in which the total amount of work done by the stomaoli
is normal, the chief departure from the normal standard
being eorae form of acid fermentation.

Column A, which has relation to the total acidity
of the stomach conteiits, has the eame normal limit ae
A'. Outside of the normal limits, however, there is
often a wide contrast between the figures shown in
these two columns. The total acidity may be either
greater or less than the Bum of the free hydrochloric
acid (HCl) and the combined chlorin (0). Wlieu
greater, the indication is that acids are present in the
stomach which have been formed by fermentation.
When less than tlie normal amoimt, the indication is
that the products of digestion are of an inferior
quality.

A deficiency of free HCl requires stimulation of the
gastric glands, and in some extreme cases benefit is
derived from the adminietration of small qnautities of
HCl with a little diluted water. When the HCl ia in
excess, patients often suffer pain or sympathetic norvoas
disturbances. The total acidity, A, compared with A',
is a good means of determining the quali^ of the di-
gestive work done.

Column S represents the quality of maltose, or di-
gested sugar, found in the stomach for each 100 cc,
or three and one half ounces, of stomach fluid. A defi-
ciency indicates either an excessively acid gastric juice
or insufficient mastication of the food. When the fig-
ures found are above normal, the indication is that the

r.RAPHIC MKTHfJI).

S5.T

activity of eaJivary digestion has been unuBually groat.
This is a condition from which no harm can arise.

The facts wliich the author's researches have elic-
ited respecting starch digestion are, for the most part,
new. They are, nevertheless, important, and have
ezcited considerable interest.

The Coefficients of Digestive Work. — Of
the several coefiScients of digestive work, coctEcient a
is one of the most valuable and important. When be-
low 1.00, this coefficient indicates an inferior qnalitj in
the digestive product. . When above 1.00, the indication
is that there are present other acids than HCl and com-
bined ehlorin.

Coefficient b relates to starch digestion. If the, i
figures found by analysis fall bt>low the norma! limit,
1.00, the indication is that a smaller amount of angar is
formed by the action of saliva upon the starch than in
the normal state. This difficulty may commonly be
remedied by the use of dry food, which naturally se-
cures thorough and prolonged mastication.

The figures falling below 1.00 in column c indicate
a deficient eecretion or a deficient quality of saliva.
Those found above the normal line indicate an nnusnal
activity or abmidanco of salivary secretion.

Coefficient y has relation to the disintegration or di-
vision of food into fine particles. When disintegration
is deficient, as shown by figures below 1,00, the indica-
tion is for the use of dry food and thorough mastica-
tion. Oranose is admirably adapted to those cases.

Low figures under coefficient z represent very slow
absorption. Figures which fall above 1.00 indicate
an UDuenally rapid absorptioo.

356

TBS BTOMAGH.

The two last-mentioned coefficients, — those relating
to disintegration and absorption, — especially the last-
named, or coefficient z, are leas exact than are the
other coefficients, jet are of considerable value, if pains
is taken to obtain the whole quantity of tluid containet
in the stomach at the end of an hoar after the I
meal is taken.

Coefficient m has relation to the work of tl:
acb in producing free hydrochloric acid to lake pai
with pepsin in the digestion of food. In bypopepsil
too little chlorin is set free ; in hyperpepsia, too mndifl
in apepsia, none at all. Improvement in hyperpepi
will be indicated by a lowering of the tigures repreaenl
ing this coefficient ; in hypopepsia and apepaia, I
reverse.

The indications derived from these coofficientfl t
as follows : —

Coefficient a indicates the necessity for tmpror^
ment in the quality of digestive work done. Electri
ity, massage, maiiual and mechanical Swedish movi
meats, and a suitable dietary, especially foods conta
ing lactic acid, as knmyss or kmnyzoon, buttermiU
etc., are necessary. Malted gluten and granose hart
also proved very serviceable in improving the quality <
the digested products.

A high coefficient x, or a and x, indicates fel
mentation. A diy diet, consisting chiefly of gran<u
and fruits, with the nse of antiseptic tablets, is f
erally required in these cases. Stomach waaluBg hm
means of lavage is also required.

A low coefficient b indicates the necessity of moi
thorough mastication or the withdrawal of starchy tot

357

from the dietary. In these cases a friiit-and-nut diet or
tho tiBe of malted gliiteu is found to be of very great
service. In some ca^cs a diet consisting chiefly of
kumjzoon, kumjss, butUirmilk, eggs, and similar foods
must be resorted to for a timo. A high coefficient b
requires no attention.

A low coefficient c may result from gum-chewing
or tobacco-using, the constant spitting having the result
of weakening tho salivary glnnds. The application of
electricity to the back of tho neck and at the pit of the
stomach is often useful in these cases,

A low coetlicient y indicates a demand for more
thorough mastication, and per]ia)is tho use of some
thoroughly disintegrated food, as granoae, for a short
time.

Coefficient z, if low, indicates the necessity of ab-
staining from the eating of lirjuid foods and drinking
at meale. ■ Special massage or manual Swedish move-
ments most be adopted as u means of increasing tho
motor activity of tho stomiich. Electricity is often
useful iu this class of cases.

^^^^^^^■^^H

^^^^^^^^^^^^^^^^^^^^^^^^^^1 ^^^^^^^^1

^P INDEX. 1

j^^ Abdomen. KBlvaiiiiatlon ot. XX.

Aiinit sallaa, 33i, ^^J

^^ AbdomlDBl baDdugt. the dry. iSO.

Aseptic dietary. S7. ^^^^^H

AspamRus. nutritive vulue of, O. ^^^^H

^H llttlngot.SOT.

Assyrians, diet of. 3a. ^^^H

Asthma of IndlgCHtion, nocturnal, .^^^^^H

develop. aU.

^^^H

Abdominal supporter. 39).

AbBlDtbc. French. 3tT,

Backache. SO. IM. ^^^^H

Ab8orbeMB.28.

bread. SS. ^^^H

Add. hydrochloric 38, Iftt. .m

Baking-powders, tlfl. ^^^^^^t

Aflrt. lacllc, a 323.

BaDano. antritlve value of. (L ^^^^H

Addlty, H7. 193.

Barley meal. 93, ^^^^H

Aeldily. calPulttled. UX

Barley, nutritive value 41. ^^^^1

Algidity from hyptrpt-uaiu. KCl..

Barley. South Busshin. nutritive ^^^^H

Apldliy.ioUi.il-''.

value ^^^H

Acne, IM.

nurley, tlmeofdlgestloAotM. ^^^^H

Batblng after meals, TH. ^^^H

^^ Alcobol, U4.

BeaDS,aeId. antritlve valoe of. 41, ^^^H

Beans. French or kidney, nutrltlva ^^^^H

^^1 Alkiil1es.l1S.

value oris. ^^^H

^^H Almond, sweet. natr[tivi> value

BeuDS,Llma.iintrltlv'valueof.41. ^^^H

^r of. 13.

Beans, pod. boiled, tlmu ot dlgw- ^^^H

i; Alum. 120.

lion of. 40. ■

Ammonia. ISO.

BeHns.strlag.nutrlI1veva]uvot.(£. M

Amylopsln. 30.

Beans, white, nutritive valne ot.iH ■

Anul Itching. 158.

Beating, maw. ■

Beuumont. Dr., 10ft. ■

^L 3IS.

^^P Anlnitl foods. SI. »r>.

Bet't. leau, m fl

^^^V Aotl-fBt dietary. Zd.

Beef, lean, tried, tlmi? of dlgesTlou ^M

^^H Aiitirebrln. IST.

of. 40. ^^_™

^B Antlpyrln. IW.

Beef, tcun, nutritive value of. 4S. ^^^^H

^H Ap»P!>iB,14I.2<W.

Beet, lean, rare roasted, time oC^^^^^H

^H Aphtha 181.

^V Apoplexy, nervoui^ a».

Be<-f, sailed, boiled, tlmn ot dl«tM- -^^^H

^^^ Appetite, excessive, LIS.

Appetites parverlfld, 120.

Apple, dried, nutritive tbIho ot, *J

llOD ^^^M

Apple, nntrltlve value ot. 41.

Beet l«a. Bit ^^^^1

Apples, lloie ot digestion of, M.

«. ^^^H

^^l Apricot, nntrltlve value ot. 41.

Beet, nutritive value of. O. ^^^^1

■

[U501 ^^M

^^^^^^

gBHy^^l

^ft THE ^^^^^^H

^H Beet, sugar, nutritive value of. i2.

Cabbage, raw. time of dtsesUoi^^^H

^M Belcblng, 1C7,

^V Beiiu>liifioluclon,X».

Cubiiage. red. autrlUre TolttA^^^^H

^1 Bicycle riding, 124, IW,

CahbAge. white. nntriUve rtUne^^^^H

^P Bllc. SS.

' BlllouHOess, fil, 177.

^^^H

Bl5Ciilt.lBI.

^^^^1

Bismuth. subtraiboDiii^ of. 32fi.

CuDcer of liver. 1S4. ^^^H

Cancer of stomach. SIT. ^^^H

^ Blackberry, nutrlilve value ol. O.

Cano-sngar, 3;*. ^^^^^|

^V Bowels, nmssage of, 30.1.

Cardamonia. lOO. ^^^H

^m BowBlB, ppolapBcd, Swedish more-

Carrot, nutritive value »t. <t ^^^H

^H nenta tor. 317.

Carrots, 9Z, 83. ^^^H

^H Brain work. ISl.

Carter's Little Uver l>ills, 3W. ^^^^H

^H BrvBd, barley, untrltlvo value

Caaeara aagrada. 533. ^^H

Casein, S. ^^^H

Catarrh, gastric, IN. ^^^^1

^H BruNd, Oue-flour. BL

Catarrh, gai>trle. diet ror.SM. ^^^^M

^H Bread, ralacil. IGl.

Catarrh, Intestinal. ISk ^^^^M

^V Bread, ryu. Qulrltlvc value or. 41.

Catarrh ot stoniaeh. a&. ^^^^H

^m Bread, 8>r.^<ll«l> sptLie tirwl. nutrl-

CaUrrh of stomach, cbronle. S^^^H

^H . tlve value Dt.tl.

Cauliflower, nutritive valiw j^^^H

^H ur.w.

Celery, nutritive value uf. IS. ^^^M

^H Bread, white, nutrlUvo value of. a.

Cellulose. U. ^^^1

^^K Bread, whole -wheat, ulitrltlve

^H or,

^^^H

^H BreadM. unlerment^d, 33S.

Charcoal, ms. ^^^^M

^H Breath, sbortness ot. lol.

Charcoal tablet*, m ^^^H

^V BrlKht'a disease la. ]»«, IW.

Charcoal t«l>lets.antlsepUt>. an. ^^^H

^B Biluian. Dr., IBS.

Cheese. S5. IDIK ISl. ^^^^H

^H Bromoae. »[.

^H Brown's Inin Bitters. 1411.

^M Btickwheat, uutrltlvu viDue of. ^1.

Chee».tltnrofdlgeBltaacitA l^^^|

^H BorkBTI. IW.

Cherry, dried, nutrlilva v»li*»i^^^^|

^^^1

^m Butler. W. IDE. 103. ItS.

Cherry, nutritive value of. IL ^^^^H

^H Butter. Freuch, nulrltlvu value

Chestnut, nutritive value <H,tf^^^^

^M Ot.1£.

Chicken souih bulled, tlmu at ^^^H

^H BulU-r. melted, time of dlgcsiloD

gcstlOD ot. 40, ^^^H

^m of. to.

Child, food for a. »!. ^^^H

LMn<.-^: diet of. % ^^^H

^H Butter. Swedish, nutritive vuluo

Cblorlds. (lied. 145. ^^^H

^^B Butyric acid, 104.

14&. ^^^H

^B cabbage. K!.

CIiinainoii'soKition, 324. ^^^H

^B Oabbattc. boiled, time or <ll|{cstloii

Clrrulallun, dli<[urbanc« ot. SKt^^^H

^H otM.

Cirrhosis ot liver. IM. ^^^^H

^^^*^^^

— d

^ INDEX. 361 ^^^1

^H Clapotcmcnt. m.

Dlarrbea. 153, 185, ^^^^H

DIukena. Cbaries, 85. ^^^H

^H Clay-eaters, 130.

nin and reglmon. SI. ^^^H

^M Cloves. IW.

Dlrti'tlc roles, £24. ^^^^H

Diet, natural. 39- ^^^H

^r Oocfflclents. 139. 313.

nk't tables. £M. ^^^H

Coldness. ISL

Oollc. 171.

DigL'sllon. ^^^^H

Coloclyster. 301

mention, allottlne time tor, 74. ^^^H

Colon, tbe. S6.

Colon, the. a reserrolr. 13.

Dlg<!stIbIlltyotvarloutitouds.tablB ^^^^H

dolors, unnatural. 151. '

^^^H

Condiment*. 34. IDO.

Dinnen. sU o'clock, TL ^^^H

OoDtectlODury. W.

Disvbsrses, the. U3. ^^^H

Cookery, lMid,M.

Dl^^onUint, 1=4, ^^^^H

Oooklnn, 98.

nisletitlon.ins, ^^^^H

constipation. B8. 153, 184, STB,

Doncbe, llver.WO. ^^^H

Doaohc, poll. 300. ^^^^H

Oonntlpatlon, Siredlsh movcmcals

Dress, benltlitul, 311. ^^^^H

ri>r,aiB.

Oonsomptlon, 18.

Drags, l£h "^^^^H

Dry dietary, £SS. ^^^H

Corn snii beans, gcccn, tlmu i>[ di-

gestion ot. 40.

Oornaro. 88.

DuJurdln-BeauRicti^ TO. ^^^^H

Corn, (lent. nutrUlve value ot, 11.

Dyspepsia, uGld. SHL ^^^H

Oorn, flint, nntritive value of. 41.

Dyspepsia, bilious or foul, Sil. ^^^H

CoTD-starcb or arrow-rout itroel.

Dyspep!<la. home treatment of, 397. .^^^^H

^1-

Dyapepsia in Amerloi, IT. ^^^H

Oora, sweet, nutritive vslac ot, 41.

Oorseti, 1S3.

Dyspepsia. Inherited, 127. ^^^H

^B Cow-trco, milk of, nntritlvo valuv

Dyspepsia, nervous. ST. ^^^^H

^m 4B.

^H Ontnberrj, nntrlllve value of. «.

Dyspepsia, simple, 315. ^^^H

^V Cnsam, 104.

Dyspepsia, symptoms of, 149 ^^^^^1

^^ Oream. nutritive voloc of, 4a.

Oroain l«rt«r, IIS.

Oucumber, nutritive value ol. 12.

Dyspepsia, troatmcDt at. iSl. ^^^^H

CniTftnt, untrttlrt value ol. tt.

Ears, rinsing In, IS*. ^^^^H

Eallug bctweoD meals. ST. ^^^^H

Date, dried. nUtrlUve value ot, 41,

Eatlns laco at ulgbt, 71. ^^^^H

David. 19.

Gullng too freqnently, W, ^^^H

Debove, 381,

Gntlns too little. F8. ^^^^H

^^ DcDtltrlce. aBtlieptIc 334.

Eating wbeo exhausted, 73. -^^^^^^|

E(.^olIon]y of vegetable food, «S. ^^^^H

^H Dessert*. 97.

Eczema, 190. ^^^H

^H Dextrin. 97.

Eel<>. vlnegitr. ^^^^H

^H Diabetes, loT.

F.KB. entire. iintrlUve value of,«. ^^^H

^^f Diabetica, diet tor, in7.

Eggs, 30. K^ 93, 2Q. ^^^H

^HD^BJ^B^

363 THE STOMACH, ^^^^^^H

Flour, bauans. xutriMve value <i|;,^^H

Ebbb. hBrd boiled. Uroo of digaatlon

.^^^1

Flour, barley, Dutrltlre tkIm flfl^^^H

^^1 EggB. 8oft'boll»d. lime of aigtsllou

Flour, bean, ontntlve value of, I^^^H

Flour, buckwheat, nutritive vala^^^^H

^^H Ekss, Hlilppcd, tlmo at dlgosdun

<^^^H

Flour, corn. DUtrltive value uf< (^^^^^^|

^^H EBi,ii>hlleot.Tiiitrlll7pvnluei>t.43.

Flour, family. ^^^^1

^^M Egg. jrolk or. nutritive valuu of. i=.

Flour, grohDm. iinirltlvc mind Of^^^^M

^B Egyptians dlc(, or. at.

^^H EDeni&.»BI.

Flour, oat, nntritlvo value of, tt ^^^H

^^H EtiGma, cold. 303.

Flour, patent, ^^^^H

^^^H EnemK, gradualc'd. va.

Flour. pcA. nutritive value of. tt. ^^^^H

^^m- Giiembla>Htlvi!.3IO-

Flour, rye. uutrltlve value ul. 41. ^^^H

1^^ Enemn. oil. aw.

Flours, glnten. ttL ^^^H

li Eneroata. nutrlllvp, 240.

Flour, wheat, nutrltlr* tbIiu) al^^^H

Enu's fruit Hnll.^UK.

Epilepsy. 3nB.

Flour, wliole-ohCBU 91. ^^^H

1 Eructnllons. 1S3.

FomunUtloD, laustnrd or turpvd^^^^H

^^B EsopbBgns. symptoms pi'ruikiln^

tiD^ sua. ^^^H

^H UMSS.

^^H Exercise. 3m.

Tuod L-onibluatlons. 7T. ^^^^H

^^H Exercise, lock or. iL-j.

l-uod. decayed, sa ^^^H

^^H mu«:les.21H.

^^^H Extracts. Savoring. US.

Food elements, deflcl^ncy In. M. j^^^H

^^B Extremities, uuld, 30.

Food, rermcnlatlon of, ID. ^^^^H

Food for brain laborer, at. ^^^^H

^^H Fitlulaess. ae. isa.

Food for muscle laborer, (U. , ^^^^|

^^H Faivdlc elect riclly, gcQcrul uppll-

Food, fried, ts. ^^^M

^^H cation* of. xn.

Food, quaotlty of. 79. ^^^H

^^H FastlDg. 'SM.

Foodpn>dacers,31. ^^^H

^H FBt,W.

Food, proper quontity of, ffi. ^^^H

^^H Put uid blood dlciiiry.^.

Food, quality or. W. ^^^^1

^^1 Fata, 33.

Food. sa1t«d. lU. ^^^M

^^B F>t8, ikbundiint useof. ini.

FcMMl, soft. 100. . ^^^M

^^m F«el. cold. Itil.

Food, too many varieties of. n. ^^^^^H

Food, uncooked. M ^^^H

^^H F<>Terdlct,£3l.

Foods. 31. ». ^^^H

^^1 FIdgcla. m

^H Fig. dried. DUlrlUv.. value of, 41.

i^^^M

^^H Fl>h,ai.

Foods, raw. DO. ^^^H

^^H Flsb, vblt«. Dutrlttvc value or. K.

Foods, sierlllwd. m. ^^^H

^^H FlStnleuue, ISA, ll«.

Foods, vegelnhle. Ha. 37. ^^^H

^^H Flatulence, IntestlDal, 137.

Foot batb. an. ^^^H

^H Flesh, sa.

^^^H

^^H Fleah food, 242.

^^^L Flesh food, excessive use of. 107.

l^^^^l

^^^ Flonr. arro«-ruol. nulrltlvu vtlue

Frogs. Zt. ^^^H

^^^K

Fmlk green. K. ^^^H

^■^^H

^^^^^^^^^^^1 ^^^^H" ■

^^^^^^^^ ISD

■^^^■^

se^^^H

^P Frolta.3T.B38.

Headache, nervous, ISO. ^^^|

^ Fullliiit!i.2W).

Health foods, UO. ^^^^1

Full balh, boc and cold, 301.

Bearing, disturbances of, SO*. ^^^H

Heurtburu. 1«4. ^^^H

Gall-bladder, the. IS.

Heat. dr7. SK. ^^H

Heaviness. I5S. 153. ^^^M

Galvanlmtlon of spine and ab-

Hiccough. 151. ^^H

domen, aas.

Ulpbatb.SOT. i^^^M

Oulvanliaclon ot symputlictlc

Holioiray's Pills. 319. ^^^^H

nerve. 3=8.

Home treatment of dyspepsia. 197. ^^^M

^^ Game. 36.

Iloner, nutritive value of. 4S. ^^^H

^L Garfield Tea. »g.

Hop Bitters. 348. ^^^^M

^m Oaiitrlujuk'e.3e.

Horseback riding, 121. ^^^^H

^K Gastric juke, excess of, IKI.

Host«tter's Bitters, 3M, ^^^^H

^H Gaatrltia, diet lur, SSa.

Hut-air buth, m. ^^^H

^m OeorgeB. 301.

^H German Bitters. 317.

Hauger.cure,-m ^^H

^m GenoB In nator. LS.

Hydrochloric acid. SB. KO. XS. ^^^H

^P Ginger. 3i.

Hyperpepsla. 113. mi. ^ ^^^^M

^ Girdle, wet, I«.

tlrpcrpcpslB, acidity (roui, ISi. SSI. ^^^H

Glands, pepllu. 19.

llypochoQdrla, 173. ^^^^H

Gleoiird. Dr., SIO.

Rypopepsia, 142, £00. ^^^M

ny!.teila,S08. ^^^H

Glateo.3n.

Gmt«Qblaciilt.Ml.

IceIftndmosB,initrlHvBvalucof,41. 1

OtuttODj, 80.

Indian meat, IK, W. J

Gofio, SU.

Gooseben'jr. nutrKlve value of, 4J.

Indigestion, septic, SSI. ^^^J

^L ot. 40.

ludlgestloua. Bymptoma ot, 151. '^^^^H

Infant, tood for a bottle-ted, Sj. ^^^H

■^ Orubamaour.ie.

Infant, tood tor a teething, £38. ^^^^H

aranolo.Z40.

Infantile dyspepsia, STi. ^^^^H

Granose, 3W.

Insanity. ^^^^H

Onpe. nutritive value ot, U.

Grape-susar. 33.

Intestinal ludlgestlon, m ^^^H

Graphic method, 333.

Intestinal Juice. £8. ^^^H

Gravies, loa

Intestine, the large. 28. ^^^^H

Greeks, diet of. 38.

Irritability, 153- ^^^H

Griddlc-cakefi. 101.

Gripes. 171,

GnalB«iolutli»l.SZS.

Japanese. dlelof,39. ^^^H

Jaundice. 18.181. ^^^H

HKUDg.3a8.

Jaundice, catarrhal. IDT. ^^^H

H&ll->M>-ealled " BocreV 310.

Joint movements, 3W. ^^^^H

^_ SBEQburg Tea, 34B.

^L Hamburg DropH, 319.

Kidneys. prolapsed.8wcdlshmov«- ^^^H

^M Baud bath. £SB.

ment^ for, 317. ^^H

Kaeudlng. 301. ^^^H

^K HCl. free, 14S.

Kneudtng. mechanical. S3S. ^^^M

Kamytooa.Stl. ^^^M

^^H 384 TBB StOMACa. ^^^H

^^H Lactic acJ(l.fli.

Mlc^rolws of ibe moatli. U,

^^^H Lamb, brolli^. tituo <>t HlgcMluii

Migraine, 177. 103.

^^B otW.

^^■^ Lappa. ISS.

Milk. 3S, 9S, W, SI.

^^B Lard, 101.

Milk and meat. 78.

^^V LHvti^. :»>,

^^^B LHVKge. hot ■nd cold. ;i^.

Milk. bollMl. time of dlgcsLlan of.

^^^1 LBxaMve:.. ISH, »£3.

^^^H Lean meat^ IS.

Mllk.eo»-s. nntrltlve value of, «.

^^H LM'a An>l-B1lloui Pills. U8.

Mllk-furriling termont, 30.

^^^V LentlK Ouriunii. iimclclvis vuluo

Milk. motUor's. nutritive valno of.

^^^V

^^B Ll>1]lll^. iitilnllvo v»liu' or. 10.

Milk of cow-treis natrlUre valne

^^m

of, -IS.

^^M LIqulil -Ik'tury, ^-

Milk, sklinniud. nutritive value ol.

^^B Llvor. m

<S.

^^^B Liver, CHiicer of, IM.

Mllk-sngar. 33.

^^H LIrrr, cirrhosis of. isi.

Mlllel, nutritive vnluo of, 41.

^^H Liver pills. Un.

Mineral waters. UH.

^^H Liver. h>rpld. 309.

Moral treatment. 314. ^^_

^^H LulHt«rG,3T.

MosMi, Dr.. sai. ^^^^^H

Motor tUDctlons. dlsturtMnoMif^^^H

■^^^H

^^H Malarial disease. IK

Moulb. Zl ^^^^M

^^H Mutt sugar, or mulloso. 07.

Moull.. antisepsis of. 341. ^^^^1

^H Man a fruglVDroas .>.1m»1.-M.

Moutb. sonr Uiile In. I6R. ^^^^M

^^^1 Manila, uutrltlvv value uf, 11.

^^B UasiaEe. M4.

Mustard. W. 109. ^^^M

^^B Uassage, cannon-ball, xn.

Mutton, brollwl, time of <tlgestloii V

^^^^M Huaagc general. 308.

of, «a B

^^B Uassage of bovels, m.

Mutton, lean, nutritive vulno of. B

^^B M<uisaReotBtoinacb,ilO(l.

^^B ^'^^^ bathing urter. Ttl.

Malton. roast^fd, time of dlgesllou B

^^^H Heals, eating bctvcen, AT.

of. 40. B

^^M Meals. Irregularity of, S7.

^^^1 McalH. proper number Of, CD.

^^B '^^'^ sleeping after. ?n.

W. ■

^^H Meals, too fr*>qurut. ce.

Nausea. US, UK. . ■

^^M Meat, "hlgb."l«i.

Nervous diseases, SIO. ■

^H Meat, raw. I«8.

Nervausneiia,S0.153.e(e. ■

^^H Meats, canned, es.

Nervous syroplonia, JOT. ^^^^^H

^^^1 Mecbanlcal kneading. 33S.

^^M Melon. DulrltlTe value of. iS.

N'eurastbenia. gastric, B7. ^^^^B

^^^1 Memory, losi of. 1/3.

Keinon, 85. ^^^^B

^^^V MonUI Impressions, 124.

New ZeaUnders. US. ^^^H

^^B Mental confusion. 1st.

Nlemyer. Dr., lie. ^^^B

^^V Mental disorders. S11.

Nitrogenous dieury. Hi. ^^1

^H Mental labor, m.

Xostmms. 34l>. ■

Numbness. IM. H

^^B

^^^^^^^w__^r~^^^^i

^^^^^^^^^^^^■^^^H ^^^^^H

^^^^m^^iB^^^^^^i

^^^K

^V IKDU. S6ff

^ KntbatMr.Ul.

Pirkles. III.

Kateremm.1l».

Plti-crust. loa.

Hot>iiMLMI.

Plaiitn. 31.

NuU,UW.Bl.SM.

Plants, pod-bearing. 38. i

Pluasant PiirKatlve Pellets, 34^

Plum, nutritive value oL 41.

OstmnLRgO.

Pork, U.

Okta, nntrlUve VBl ue ot, 41.

Path. Dutrltlre value ot. 4S.

ObBsltj, »T.

Oil rubbing, aot.

Olli. v^eMble, »

Pork, salted, tried, lime of dlges-

OnloQ. DQtntlvc valud ut, O.

Uon ot, to.

PoPtnlclreulBtlon.Sl.

Ore reft ting, W.

Ojiw™. 37, IM.

Pw>[l1oaa. bad. IS.

Oysters raw, tlms of digestion of.

Potaloes, 9E. 93.

to.

Putatovs. Irish, baked, time of di-

Ojriten. •Mmd, time of digestion

gestion of, 10.

ot,«0.

Potatoes, Irish, boiled, tune of di-

gestion ot, to.

PHa. lO. IT*.

Potato, nutritive value of, 41.

PklpltatlaD of the heart, m.

Potato, sweet, nutritive value of.

P>rk«a,«g.

42.

ParsDlp, aatrltlve nine of. 4£.

Poultry, nutritive value ot.tS

Parenip* M.

Pour.hot and cold. aoo.

Ponnliw. tjoUed. time ut dlgestloD

Prolapsed colon. Swedish move-

at. 40.

mEula tor. 817.

pMt«ur. 19.

Prolapsed stomach. Swedish move-

Paslrjr. DO.

nn:nt5tor,317.

Peacb, nutrlUTS value of, tl.

Prune, dried, uutrltlve value of.

Peach pickles. 111.

Peanut, nutritive vnlus of. «2.

Pear, dried, natrltlvc value of. 41.

Itomalnik 19.

Pear, natrltln value of, 41.

Ptyallu. a.

Pea9,«l.n.

PuBlllsts, B9.

Peu, African, nutritive value of.

Pylorus. SB.

PeBMDta.(lletof.3B.

Pyrosis, ins.

P«u.Ci«eii,eardeD,notnitTeVBlDe

ot.4S.

Quacks. 34!i.

QuButlty of food. Tft 1

value of. 41.

^■a

^^H

Peivudiung.aae.

Radway's Begulallng Pills. SI8. ^^^H

Pepper, 34. W.

Ralslu, nutritive value of, tl. ^^^H

Pepper. Dr., IM.

Raspberry, nutritive value of, tl. ^^^H

PepperHBUCe, M, lOB.

Eectum, symptonis pertaining to. ■

Pepsin. 19.

KB. T

Pepsin, what about T ttl.

Peptic Kland>,n.

R^mond, SBL J

Peptogen*. 38.

Peptonea, 19.

Rest-cure. 329. 1

Perfection Vaporlier. m.

RheumatUm. IM. 1

^^^A

^^H^^^^^^H

^^^^^^^^^pi^li^^^^^^^^l^^^^^^^^^l

^W 366 THE 8T0MA0H. 1

^r HheuiaaUHm i.rid goul. rtl.^t tor

lilci'plxsatMr mnla.73.

Klce, M. sa.

Smokod meats. 37.

nice, nutritive value of. <1.

Soda, bicarbonate ol, 83S.

SootblDg gyrap Mrs. Wlnsloit'a.

Bobcrts. Dr. William, UX.

Romans, diet of, M.

Boreueu. ITS.

Rowing, 13*.

Rabbi Dg wet-abeet, SgL

*0.

Rje meal. I& 03.

tlou of, to.

Soup, multou, lime of dlge.UoB of.

41.

40.

Rye. wlnier. noHiClre suluo of,

Spinach. Duuitlve valuo ot. 4a.

Spine. ^Ivunliatlou of, SEN.

Splue. beat and cold to. SW.

Sago, llmo of tlieestloii ul. «>.

Sponge bath, 2)0.

DBleretns, iia.

Squash, nutritive value of, 48.

Saliva. B.

StammeTlQS, IS3. ^^^H

Starch, ffi, to. ,^^^^H

B«llv»ry glaniis. 2i,

Balcdon, uulrlilve value of. «.

Starch granules. »7. ^^^H

Salnion, salteil. boiled, cimv of dt-

gesllon of, 10.

Starch, ra*, 91. ^^^^H

Salt, m 110,

Sieaptln. 30. ^^^H

Kattglow, 201.

Martin, 10». ^^^^H

Salts. 3S. 33.

Stomach, £1. S. ^^^^M

Salted meats, 37.

Stomach Bitters, 847. ^^^^H

Sarologa i?h1p«. 101.

Stomacb. earner otSTT. ^^^^H

Sauerkraut. Ifll.

Slomachi cutatrh of. SS5. j^^^^^^t

Sourvy.flO.

Stomach, cliranlc caUrrb ot.tf^^^^H

ate, M. GeroiBUic. S3.

.stomach contents e».nU>S^^H

BeHier, 324.

^^H

stomach coagb, IH, SOG. ^^^^M

Sexuul abuses. HA.

stomach. dllataUon ot IS. aL ^fl^^^^M

6bell-fisb. 37, W.

Stomach masuige. XS. ^^^^H

aiRhlng. 154.

Stomach, pressure ol. 121

Shower balli.a81.

aiomach. prolnpK of, Sid.

Slgbt. dl&lnrbaoces ot. 2m.

Stumach, prolapse of. fiKMltali

Simon's LUcr KeKulator, ;h&

movements for. n7.

SlnkliiB seusallon. 178.

Wnusoldal eurrent. hlKb l^u-slon.

Stomacb-tabe, MO. UI.

Stomach, ulceraUon of. dtv) ftt».

StoDi<>-h.iilcernf.am.

SItup, Dtitrltlve value of, f!

Slomai'li. uueusluew al. l.V.

SIU bntb, m.

StodK IBT,

skill, dryness of. mo.

KUKils. lutlnful. ISJ.

Kkln erupt Ion », ISO.

sionghlon BlTlers,aie.

1' Hlocplng. HO.

Mrawbsrrj. nutritive vuhio ot,4L

^^^^^^^V^^H

H^^^^IH^HH^^^BI ^^^^^^1

^M' ihbbz. 367 1

StraiiKtli, mllng For. S?r.

Turnips, flat, boiled, time of diges-

!<UL'l. 101.

tion of, <0.

Bngar, 38; 40.

Typhoid fever. IS.

aiig«r, use ot Id excess. U».

TyrotoilcoQ, ai.

Sulphur. 3S4.

8unbulh.Sge.

Ulcer of EiomHcb. SiS.

Suppera. InlA. TI.

tirlcacid crystalh. ISt.

Swedlab movKmeol* mechanical.

Drlue. ISO.
Urine, scanty. HU.

Swoetmeiits, 87.

Van HelmoBi. IM.

ot.Wk

Vapor bath. m.

Byniptoois, sonenl nurvous, IB3,

Veal, tried, time of digesUon of. ^^^M

Tapeworm. 18.

^^M

Tea drnnkonness. ».

Veal, nutritive value of, «£. ^^^^M

Teeth. £1.

Vegetable fats. 101. .^^^M

Teeth, permanent, 3t.

Vegetable foods, 37. ^^^^M

Teeth, BlructQre of. lOD.

Vegetables, 33. ^^^H

Teeth, temporary, a

Test meal, 1S4,

Vegetables, raw, 87. ^^

Theln. m.

Venison, broUed, lime otdlgeitloh

Throat-all. 18S.

of, M.

Vibrating chair. 38S.

Villi. 38.

Tight lacing, m

Vinegar, 34, 10», IB.

Tightness. 172.

Vinegar Bitters. 317.

Tingling, IM.

Tobacco, 117.

Vomiting, isa, IflT.

Tomato, DUtrltlTO value of, <£.

Tomatoes. lU.

Tonic treatment, general, 333.

Walnut, nntrltlre value of, a.

Wat«r-bnub,HUS.

ToLguB, coaled, at.

Tonsils, a.

Water, bard, 118.

Toxins, 19.

Water, Impure, 12B.

Tra»ellDg.3i3.

Weight, 178.

Tropic Fruit Laxative, 3tlL

Wet-sheet pack. M3.

Wheat. Japanese, nutritive value

TruDlE pack. XM.

of, 41.

TruDic pack, bat and cold. KM.

Wbest, Michigan, Dleble, nutritive

Trunk ml Hog, SX.

Trypsin. 30.

Wheat, Ulchlgan, white, nutritive

value or. 11.

Wheat. Poland, nutrlllve value of.

Turkey. roUt«d, time of digestion

Turnip, while, nutritive value of.

Wheat meal or bread. B3.

42.

Whortleberry, nutHtlve raluo at.

^^^M

• ■*%

. 4

THE ART OF MASSAGE.

By J. H. KELLOGG. M. D.

Th« most complete and thorough work upon the subject of n
ever publisbed. Illustrated by 139 cuts and 10 finely colored anatom-
leal plates. Concise directiaus are given Tor all the different procedures of
sctentitic massage. It ought to be in the hands of every nurse.

The Perfection Vaporizer.

Is especially adapted to the
treatment of diseases of the
nose, throat, ear, brondiial
tubes, and lungs, both acute and
chronic. Many severe spells of
sickness can be avoided by its
early tise. Is especialy recom-
mended in "La Grippe," when
afTecting the air passages, hay
fever, and asthma.

Full directions and formnlEe
with each instrument.

MODERN MEDICINE CO.,BkT\\.t C'ssxx-,'"*^^^!^

Ml nis OF 1 11 Fiei

The accompanying cut represents these outline Charts mounted
D a convenient Exhibitor, which is SO arranged that both the Charts
md the Exhibitor can be snugly packed in a compact case.

C/0

THE following expression regarding the value of Dr, Kellogg'i
"Outline Studies of the Human Body," is from Jay W. Sea\-er,
A. M., M. D., President of the Chautauqua School of Physical Edu-
cation, and Medical Director of the Yale University Gymnasium ;—
"Dr. Kellogg's 'Outline Studies' I am sure will prove to be
very helpful to any person who is studying the human body, or who
is teaching personal hygiene. These outlines should be widely in-
troduced into public schools, where their mere presence on the wall*
would be a constant object lesson."

MODERN MEBIGINE PaBLlSHING GO.,
BATTLE CREEK, MIEH.

SomethiDgGoodrZC

A nrw cereal preparation made from the choicest wheal, by a process
which retains all the elements of the grain. By combining the proc-
esses of digestion, cooking, and roosting, by the use of special macliin-
ery, the wheat is brought into the form of delicate HakcE, in which the
bran is thoroughly dUlntegrated. and the starch largely converted into
dextrine, and thus made ready for solution by the digestive juice and 1
for prompt assimilation.

L -^GRANOSE*-'

■b crisp, delicious, appetlzlntCf and digests quiclcer than any
lather cereal preparation. It clears oH the tongue, rids the
stomach of germs, and cures constipation.

It is unique; an Incomparable food. Babies thrive upon it.

BATTLE CREEK SflNITftRmW HEftLTH fOOD CO.,

Battle Creek, Mich.

Antiseptic- Charcoal,

Tablets.

•••• These Tablets consist of a newly pro
duecd form o( vegetable charcoal,
which has been shown by eiperience to be possessed of superior
qualities, with which are combined vegetable digestive agents
and Intestinal anti^ptlcs and antlferm^nts. In these Tablets ]
charcoal Is for the first time presented in agreeable farm.

. When to be Used.

The use of these Tablets is indicated in all cbbh of Stomacb
and intestinal Indigestion, and especially in cases in which
the following symploms are present : SoUf StOntach, Of Acid

Fermentation, Bloating of the Stomach or Bowels,
Flatulence, Eructations of Gas, Foui Tongue, Bad
Breath, Unpleasant Taste In the nouth, Biliousness.
Sick Headache, Nervous Headache, and Constipation.

Dose: Ont

o four Tablets alter each meal.

MODERN MEDICINE CO.. Battle Creet fttod.

Nut Meal.

■
I

Ibe food product

Th!« prtp«™Uon li mide troat e^refnllr »■
Itdcd and prepstcd onti. II nprMtnt* «■*
of tb« mMt DOurUIilns and dIsertlUc ef all
f the TCEcUblc kiagdam. 11 ii ripcciilly sdapicd for pa-
ifficully in diB«liog atanh, and lor tbOM wko 1t*4 W
InNuh. It agreu well with the moit del
gelled when the (tomach Kill tolerate notbing tiac.
Meal a»} be eaten dry, or conblncd with otbcr loodf, or ml
1lh the addllloo ofa lillle ult. ilioak

a UtUi

deliclou

Nut Butter.

vlei, uuce*. etc. TborouKhlri
In water; has a rich nulty fiavc
keep* well. Is Iharouihly (tcrl

can be urged agalnit animal fai

Almond Meal

■igaed Tor dlabetlci and Invallda wh
nutrilloui, ciccedlnxly dellcals and

Malted Gluten

A caplUI (ubatltHU tor anlaul Ma ■<
■II lorti In the acatOBlag or aborMi*
log of lood«, la the preparatloa ■! gr^
vlei, uuce*, etc. TborouKhly cooked and emulnlGcd. lo it diuotTe* teadUr
In water; has a rich nulty Savor; la tieecdiDgly palatable aad dlgestlM*.
keep* well. Is Ihanmihly Mcrltlzed. and fret fiom all otijeellaa* oblcb
can be urged agalnit animal fal*. II girei a mealy flavor to aou^

Tbia I* •Imply • fine meal p(»

pared from the chaloil

MaBcbed almaadt. eopccUlly dc-

■igaed for dlabetlci and Invallda who cwmot dlgeit *t<rcb. Ii la k%My

nutrilloui, ciccedlnxly dellcals and palatable, and an adnliabte food Ifar

MBDIA'

! ABSORPTION. TtaeK>ut<

and Is 1
.e digMI

' of fine dlvldOQ
Clulen

1 the larlnaeeou* hot
( In a ilalc of compteic
1. REAOV FOR IM-

aiaa has been lubjerted
, « tfa.I It U promplly

Indefinitely. II

that MALTED QLUTEN IS A PERFECT BLOOD AND PLESM-MAKINa
FOOD. II is free from the impleaHnt Bivor of the variou* loeal peptoaea,
and is especially sdapled lo thoie caaei requiring perfect lateatloal aHpsia.
In which meat peploaea and meal preparatlona of e*ery description arc cod-
tTa-lndlcaled. It has proved a floverejgn rciDedy la caaea €rf BcrviMW b e ad
■cbc, sick headache, obstliute naDsca. and vonttlng. and Bunenms caaea
lo which all olher food aubslanccs weie lejected by the itomach.

Bromose. -'.rJ":i

Kavi

ance? WOULD VOtl UKE TO BB FAT r Wa
: EAT BROnOSE i

. exceedingly palatable food preparation, cooalata of cereati
■h the lUrch is coDplclely dtgeited, the oula perftcUy
fal emulsified. It I* thus ready far iramedlile assimila-
tion. II is the most easily digested and moil faltealng of all foodi, and at
the lame lime rich in proteldi. and henoe UNEQUALED AA A TISSUB
BUILDER.

BROMOSe makes fat and blood more rapidly than any other food. II
is the food par eicelleoce for blood, bnln. and nenei. Innlldi wba«
troubles are due la ihe fad Ihal they caouot digest Ibe atiieh of cereals aad
vegetables, flnd In BROMOSE A PANACEA. Bromose Is rich la salt*, H
well U protelds sod food elementa. It Is uceileDl for wMk, fd«ll< l»-
vallds. and feeble children.

SANITAS roOD COMPANY, Bottle Creek, Mich.

Sanitarium Medical Battery.

THE ADVANTA6ES CLAIMED FOR THIS BAHERy ARE

I Efficiency, Durability,

of Construction,

THE CELLS HAVE THE FOL-
LOWING ADVANTAGES.

The elements are zinc and carbon.

The excitant is a solution of muriate of ammonia (sal ammoniac)

and water.
There are no fumes nor strong acids to corrode battery parts.
They will run for medical purposes many months without the

slightest attention.
There is no consumption of the zinc element when battery is at rest.
They are perfectly sealed, so that evaporation is impossible.
High electro- motive force. Small internal resistance. Great power

of recuperation.

pmicm, WITH MLMCTifOoms, cOMPLeTM, 910.00,

MOBERH UBDICmE CO., *».VV\s. Cv«.<>8.,"«J>!3'

COMBINATION

Watsr MIe and Fountain S fringe.

This combination was first arranged by us a number of yean |
ago, and we have had hundreds manufactured for us. We have re- J
cently arranged for the maiuifacture, for our special trade, of thiftl
convenient combination in an improved form. It consists of a saV I
stautial water bottle with funnel neck, a safe and durable cap, andl
E six feet of fine improved tubing, with suitable attachments for o
necting with the bag. An outfit of the usual syringe tubes is c
plied with the syringe, and the whole is packed in a neat i
substantia] tin box.

PRICE, complete, , . , - $2,001

Postage, 25 cents.

MODERN lAEDiaUE CQ.,Bwt:l£ Crbek,

EAR DOGCHE.

^^HE continuous application of hot water
j!p' to the ear is a raost valuable means of

preventing the destructive inflamniation and
loss nf hearing in cases of earache, and in the ear
troubles which accompany diphtheria, measles, and
scarlet fever. The objection to the employment
Mi' this remedy is its inconvenience. This device
]K*rmits of the application of a continuous stream
of hot water with the patient in any position
without danger of wetting the clothing. Its timely

will often save life-long inconvenience. It ought
to be in e\'ery family.

SPIME: BA<SiS.

RUBBER
SPINE
BAGS.

Verj- strong and (UuMbif , i,-.--i.nnal m iht- ireatiiicnl ol" some forms
of Dyspepsia, Spinal Irritation, and many nervous diseases.
PRICE, 20 Inch, postpaid, - • - S1.40
26 inch, post<paid, - - 1.66

= HOT -WATER BAG.

As a foot-warmer, or for applications of
either moist or dry heat, this bag is invaluable.
For moist heat, wring a flannel cloth from hot
water and lay on the bag. It is a durable
article, and one not wilUngly dispensed with
after once using.

Price, post-paid, »1.S0.

MODERN U^XSVOCS^ "C^-

tDiilcanized IRiibbep ITce Bags.

Hhese bags are designed for making applications of ice to the ■
} head, throat, or spine. Where ice cannot be obtained, very coldj
water may be used. It avoids the necessity for wet cloths, wbidlj
wet the patient's clothing, soil the bedding, and require cotistantl
renewal. The mode of fastening renders the bags water-tight.

PRICES.

No. 1 50 cents.

No. 2 (narrower than No. i ), speci-
ally adapted to the bead. 50 cents.

No, 3. Specially adapted to the
throat. Made of pure gum,
and furnished at the follow-
ing prices: —

7 inches long, 50 cents,

8 inches long 60 cents.

9 inches long 65 cents.

I inches long 80 cents.

Postage, each, 4 cents.

HEAD BAGS.

Beneficial results may often be obtained by the use
of one of these bags in cases of headache. They an
very light, and can be filled with either hot or cold
water. They are easily carried and readily applied.

Price, 32.00. Postage, 5 cents.

iDstrtiraenf for the flppIi^atiOD of Heat to the Uagina.

It above shown has been devised for the purpose of appljrjn
dry heat to Che vaginal walls. It may also be used for cold applications, i
alternate hot and cold applications ia this region. It is used in conDftcde
with a fountain sjringe, a current being passed through it either hot, col
or alternalel/ hot and cold.

PRICES : No. 1, $1.25 ; No. 2. Si.oo ; No. 3, 75 ceaU.

MODERN MED\CWt CO.,■e.^•K^v■^. <:>,«»

THE NATURAL ABDOMINAL SUPPORTER.

Ought to be worn by every

woman who has the
shape of Fig. i.

Cures backache, headache, drag-
ging sensatkiii, and many
other discomforts.

P^ISICE, FOST'F.a.iD, ^S.OO.

Clubs and Dumb-Bells.

By the use of these the muscles can be
exercised aud developed, giving vigor, appetite,
and cheerfulness to the user.

SIZES: 1-3, 8-1, I, 1 t-2, 2, 3 1-2, 8, and 4 lbs.

The '/^ lb. is adapted to the use of children

from 2 to 4. years of age. The ^, from 4 to 8

years of age. Prices given on application.

We fiimish outfits for home gymnasiums at various prices

from $10.00 upwards. One of these outfits ought to be in every

home.

SEND FOR CIRCULAR AND PRICES.

MUSCLE BEATERS.

Simple, cheap, and efficient instruments for
securing some of the effects of massage. By
their habitual use one can obtain most beneficial
results without the aid of an expert.

Price of Ball Be&t«r, postpaid, - $1.40
Price or I'lliiger Bealer, postpaid, 2.15

MODERN MEDICINE C0.,ftKV\V5. Cvsst.,-«v\'=xv.

Umbilical Belts.

Made to order of any size desired.
PRICE, $1.50. Postage, 4 oeou.

Air Pillows.

Air Pillows are always cool and restful. They can be a
at will. Just the thing for camping out or traveling. Can 1
packed in small space by letting the

PRICE,

. I, Sateen cover, gx

$1,60
2.50

Invalid Air Cushic

These cushions are unsui
comfort they afford to very thin j
sitting, and are also essential as a d
preventing the formation of bed-si

PRICE,

diameter (postage, 10 cents),

$t.i

Exhalation Tube for Lung Developmen

I The EzbaUtioD Tube is one of the most effective means for luag de«clop>
t. It can be earned in the pocket, and can be osed at any time wilbon
interfering with other occupationa, and caii thus be made to act contlnootvl}
in developing the lungB, expanding the »ir-cells, and deepening the rctpitBtofy
jnovemeDts, It is worth many tkacs \Va "uti^W
Htaur oCber person whosa Inngs kic ve%^.
^^L MOOBR.N (AtWCWE. «>-.^-^i

PERFECTION

Douche Apparatu

-i-

"HIS apparatus consists of a pail
for water, with a long rubber
tube, and a convenient bed-pan.
It is made of tin, and is light, dura-
ble, and easily cleaned and disin-
fected.

It is especially useful for giving
douches in cases of confinement, and
to feeble patients who cannot be removed from the
bed.

It can be adjusted under the hips without moving
the patient, on any form of bed or mattress.

Any amount of water can be
used, the water running out as '
fast as it runs in. To start the
water running, close the rubber
tube by folding it below the bulb,
and then squeeze the bulb, which
will at once fill with water when
released. Then open the tube, and the stream will
continue to flow till the pan is empty.

^■Complete $2.25.

^■Douche Pan, without fountain or tubes, 1.35.

^B Sent by e:K^t^%%.

^■ODERN MEDICINE CO..^^T\v.t C-vs.^'*^,'^^'^^-

RECTAL IRRIGATOR.

fllE great prevslence of diseases of Ihe leclum, and the lecof^niied xl*a>U(«i
uf hot water in the ircBtnicDl of 'diseases af mucous raembriuies. led, mtoiI
years ago, lo the iovenlion of the hard rubber reclal irrigator, of wlucli the »■
ventor speaks as follovi : —

"The virtue of hot water as an agent in removing the thickeningm and indi
which rciult from chronic congestions and inflaminalions of mucous surfaces and

(iguous parls, has long been recognized. In the irealment of pel*lc is-
duiations resulting from cellulitis, no agent ii to polent as the hot
vaginal douche. Dr. Emuielt states that be regards Ihit one •{ml ■
more valuable than all other local measures combined. The raise «l
hot water in the treatment of rectal diseases seems lo have been
appreciated by Ihe profession, Ih'iugh leeentlj' it has been used bf
rioui specialists, and with excellent results.

"For some years I have used hot water by means of the conlinu
enema, and with most excellent results; but feeling the need of (one be
mode of applying hot water lo this pari of the body, I have cup
menled with various forms of inslrumenls for ihe purpose All the ift-
slrumenU 1 found in use were loo large lo be used without discomlocl,,
in most cases, and all were made of metal, which is wholly unRi fat tht^
purpose on account of its great conductivity of heal. The mncoui men*
brane is much mote tolerant of heat than ii Ihe skin. When a melallic'
instrument is used, the heal transmitted to the very sensitive surface at
the jUDclioii of ihe skin and mucous membrane become* anbeaiable be-
fore the Icmpcralure is high enough lo make the applicalion of muck
value. I have bad made an instrument, which I believe embodies tli* .
excellencies of instruments previously made, and several additional ad-
vantGges, chieHy Ihe following: —

"I. Il is made of hard rubber, a poor conductor of heal, which ^
lows the use of waler as hoi as the mucous membrane will tolerate.

"I. The instrument is of tuch size that it can be easily used even in

tbosecases in which there is unnatural coniraclioa of the sphincter miuelea

from the irrilalion of a rectal ulcer or Essure, the class of cases in whick

an instrument of this sort a of grenlesi service, and in which olhei !*•

I slrumenls can seldom be used, never with water of proper temperilnre.

"3. The sleeve of the inslrutnent is notched at its outer eitremilj

to as to prevent obstruction to the return Bow when the inner tube is pushed in a* far

as is allowed by the stop.

*'l have used this instrument in the treatment of hundred* of cases of rectal di*-
eaies of various sons, and have found it a most sailifaciory and eSective aid in the
management of ihis class of diseases."

CAN BE USED WITH A IVY SYRINGE.

DlrectlDni lor ok iGCOiDpariy each inatniBCDl.

niU, pHUgt ttii, ilM. WiU liiTttul Sjilu ijtiMgt. nJi; (Mtifi It I

MODERN lAEDlCWt CO-.feKvw-t C»sH(-,'»*<i-A.

: n

■•'• •'» i

!,i:ffi

LANE MEDICAL LIBRARY

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